of
Researched and Compiled
by
Ms. Sheng-wei Lan, C.A.H.S., 2004
Chinese-Ayurvedic Herbalist Specialist
This topic of manic-depression (now referred to as bipolar
disorder) and its treatment interests me due to my studies in Traditional
Chinese Medicine at
As my research question, I will find out which treatments – TCM, Ayurvedic and Western medicine / psychotherapy – are most beneficial and what the limitations of each treatment are.[1] Especially when working with emotional and mental problems so common in today's fast-paced Vata[1]-genic and competitive Pitta-disturbing society, it is important to simultaneously study and use several methods (not just Western psychology and psychiatry or drug medicine), integrating them into one. This point is shown in the ancient East Indian Vedic literature: “By knowing one science alone, one cannot arrive at an accurate scientific assessment. Therefore, a physician should study other sciences in order to arrive at correct diagnosis.”[2] Therefore, in this paper on manic-depressive disorders and its therapies, I will discuss mixture of modern Western biochemical psychiatry and psychology, TCM, East Indian and Tibetan Ayurveda, and the ancient Asian philosophies of Buddhism[3], Hinduism, Taoism (Dao de Jing[2] – Zhuang Zi) and Confucianism. In the last eleven months of study that have resulted in writing this paper, during which I have been learning these healing, religious, and philosophy arts of Asia combined with modern psychology, I have discovered that “the truth is one” and that they are all (in the traditional Buddhist metaphor) “fingers pointing at the moon.”
I expect to discover evident that TCM can receive good results in the treatment of manic-depression (bipolar disorder). [4] My focus will especially be where there is a more common frequency of manic episodes since that is the tendency of my case study patient mentioned above (who I treated for 11 months now).
Because
of my limited financial resources (just a student), I chose a “survey method”
for this study – which I have summarized and included in the Appendix B the
actual research documents. I first
developed questions which focus on my topic of TCM treatments for bipolar
disorder with a focus on the manic episodes.
I then interview a group of 12 Licensed Acupuncturists and Doctors of
Oriental Medicine (D.O.M./O.M.D.) from the
Clearly, mental disorders like manic-depression
take a big toll on our lives. Efforts to
understand manic-depression disorder depends on research in different areas from
cell biology to sociology. “About
one-third of the
Although it is not the only method for classifying mental disorder, the DSM-IV has strongly influenced most mental health environments - from diagnosis to treatment to medical insurance billing. Therefore, much of the terminology for the disorders discussed in this paper comes indirectly from this large manual “used to provide a common language for therapists, researchers, social agencies, and health workers.”[8]
The most important aspect of Manic-depression disorders (bipolar) for my case-study patient are the manic or anger aspects: According to the book Rooted in Spirit – a translation of the Lingshu portion of the Huangdi Neijing, “when the accumulated pressure” of anger “explodes, blood and breaths are taken massively toward the upper regions. When it is held inside, the internal agitation and dissatisfaction generate blockages that have no resolution. Blocked situations that have no resolution eat away at us.” (Larre-Rochat:95: 168) This is when anger with fire rising eats away at the liver and heart and lungs as is seen in my case study patient. But it all starts with the liver disturbance. The authors of Clinical Applications of the Yellow Emperor’s Canon on Internal Medicine say “The liver stores blood and houses the soul, it cannot house the soul when heat disturbs liver blood, and restlessness of the hands and feet, fright, talking too much or too little, poor sleeping or an unclear mind are encountered.” (Wang 99: 117 Chinese, 272 English) My manic case study patient has hot liver blood, restless legs, feet and mind, with too much talking (require by his computer engineer job), and poor sleep (cause by computer work late at night). The authors of Rooted in Spirit go on to say, “Anger corresponds to the liver. When it expressed the normality of the Wood element, it is the very impetuosity of life, especially in the power of things at their beginning. It is the strength of wind that blows, or the young plant breaking through the still-frozen ground, or the fierceness of birth that expels a being into the light of day and then causes it to grow and unfurl. Wind is the ‘anger’ of Heaven.” (Larre-Rochat:95: 168) This describe well my patient when he is “healthy” or “in remission.” Rooted in Spirit continues on to say, “Pathological anger is perverse movement of the Wood. This is the force that unleashes impulses and pushed them to their extreme; it is the upward leap, the impetuosity that carries everything along before it. When it breaks its moorings, leaving its roots, and goes out of control, it is rage, unleashed fury, and irrational anger.” (Larre-Rochat:95: 168) These above three paragraphs are good describe of my manic case study patient in both “remission” and “active disease.”
Manic-depression disorders (bipolar) are manifested by over-confident, talkative, excessiveness, over-spending (money, time, energy) and hyperactive, followed by short times of depression and thought of suicide. The symptoms of manic-depression disorders look like those of schizophrenia (Wu 91: 256-257). There are also genetic factors, and some mental illness, such as schizophrenia or mania, may be inherited.[9] “This affective disorder is marked by severe pathologic mood swings from hyperactivity and euphoria to sadness and depression. Either the manic or the depressive episodes may predominate, or the two moods can be mixed.” (Eckman-97: 46) The brain can be affected in a way which is illness but is not necessarily mental illness according to usual definitions. A tumor in brain, for example, is not likely to be very much different from tumor in any other part of the body. There are many other examples of this kind. Cerebral hemorrhage, or stroke, is an organic condition, and not a form of insanity.[10] But, in any case, human body is complex and integrated, and definitions are only useable within certain limits. In other words, as the Tao Te Ching says, “The Tao that can be told is not the eternal Tao. The name that can be named is not the eternal Name. The unnamable is the eternally real. Naming is the origin of all particular things.” (Mitchell 88:1) What I mean by this, is that naming and definition are limited – they are not the whole person themselves, and they can “cage” the patient into the identifying their label mania as an inseparable, and therefore incurable, part of their personality. So by labeling the patient “manic” or “schizophrenic” you are reinforcing their identification with the named disease. On the other hand, the TCM method is too diagnose them via unique individualized pattern discrimination as “liver-fire rising – with phlegm heat harassing the portals of the heart” (gan1 huo3 shang4 yen2 – tan2 mi2 xin1 chiao4). (Wiseman 98: 135) (Mong 01: 137) This way, we can treat the patient without labeling them.
The DSM-IV recognizes 10 types of Personality Disorders:[11]
The DSM-IV mentions people having manic episodes may have “a pattern of disregard for, and violation of, the rights of others. This pattern brings the individual into continuous conflict with society.”[12] This is often seen in liver-fire-phlegm (pitta) disturbed patients. As with Histrionic Personality Disorder, manic episodes may show a need for drama or “acting out” - most pitta disturbed persons like such theatrical episodes. I have seen with this one in my case study patient’s actions at times. Some call it “drama addict.” The influence of TV and movies have contributed to this phenomena. In Avoidant Personality Disorder, we see manic-depressive tendencies with “a pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation.”[13] This would be a pitta disorder. Pitta people, like my case study patient hate being criticized.
“The common cold of psychopathology”[15] everyone has it at some time or other - that deep and long lasting sadness. “One European study found that people with recurrent depression spend a fifth of their entire adult lives hospitalized, while 20% of their sufferers are totally disabled by their symptoms and do not ever work again.”[16]
“21% of females and 13% of males suffer a major unipolar depression at some time in their lives.”[17]
Combination of manic and major depressive alternation. Severe depression (kapha), followed by mania (pitta), then back again. Manic episodes – Abnormal and persistently elevated, elated and expansive mood[19] “Sometimes the individual's predominant mood is irritability rather than elation, especially if the person feels thwarted in some way.”[20] These mania symptoms are all pitta liver fire phlegm symptoms: Abnormal big feeling of self-confidence; Unrealistic belief that they have special powers or abilities; Decreased need to sleep; Too much work, social, or other pleasures; Uncalled-for optimism; Take unnecessary risks; Promise anything; May give away everything. My patient has many of these. The standard Traditional Chinese Medicine textbook from Beijing, Chinese Acupuncture and Moxibustion (a required basic text in my current TCM studies as the Academy of Chinese Culture and Health Sciences) states that “depressive disorder is manifested by mental dejection, reticence or incoherent speech, while manic disorder by shouting, restlessness and violent behaviors. As described in Classic on Medical Problems, depressive disorder is caused by excessive Yin, while manic disorder by abundant Yin, while manic disorder by abundant Yang.”[21] I treated my manic case study patient with acupuncture and Chinese herbs (many different), Ayurvedic herbs (Brahmi [Centella asiatica or Di Qien Cao in Mandarin]) (Reid 95: 129) (Tierra 88: 200) and Western herbs (St. John’s Wort) (Tierra 88:199-200), lifestyle and dietary changes and suggested Buddhist meditation and repentance ceremonies. He mostly have symptoms of manic episodes much more often than depressive episodes. “The most important etiological factor of manic-depressive disorder is emotional injury. Pathologically, Phlegm plays the primary role. Depressive disorder is due to stagnation of Phlegm combined with Qi, while manic disorder is due to Phlegm fire. Although they are different in symptomatology, they are related to each other. A prolonged depressive disorder, in which fire is produced by Phlegm stagnation, may change into manic disorder, while a protracted manic disorder, in which stagnated fire is gradually dispersed, but the phlegm is still existing, can change into depressive disorder. Therefore, they are termed together as manic-depressive.”[22] (Wu 91: 256-257) (Wiseman 98: 135) As an example: “Kay Jamison had a major bout with mania, filled with hallucinations and delusions shortly after finishing her Ph.D. in psychology. Despite her academic training, she was unaware that she was a manic-depressive and needed to be on lithium. In defiance of her academic expertise in the area of depressive disorders, like other manic-depressives she would sometimes stop taking lithium because she was addicted to the highs of mild mania. But extreme depression always followed, and after one of the more fierce high-and-low cycles typical of manic-depression, she attempted suicide and went into a temporary coma. After coming out of it, she said, "It was very clear to me…that if I were going to live, I had to stay on lithium."[23]
According to Bob Flaws, in his article “Thoughts on the Integration of Chinese Medicine & Western Psychiatry”, “One of the fundamental and important statements of methodology in Chinese medicine is, ‘Same disease, different treatments; different diseases, same treatment.’ In Chinese medicine, two patients with the same disease presenting different overall patterns receive different treatments. This is because, in professional Chinese medicine, treatment is predicated on the patient’s pattern first and foremost and only secondarily on their disease diagnosis. Conversely, two patients with different disease diagnoses may get essentially the same treatment if their patterns are the same.” (Flaws TCM-Western Psychiatry 2001) Therefore, although we are talking about TCM treatments for manic-episodes in general, we must always remember that TCM treats individuals with specific “TCM patterns” based on classical “TCM pattern discrimination” diagnoses, not general western disease names like Manic-Depressive. Ayurveda works the same way as TCM in this regard. Again from the above article, Flaws says, “This is what makes our” TCM “treatments safe and effective, because they take into account the patient’s whole situation, not just their disease diagnosis.” In Combined Treatment of Depressive Episodes with Acupuncture & Psychotherapy,” on pages 65-66 of that journal, “At the same time as acupuncture, patients were treated with psychotherapy. This consisted of guided progressive muscular relaxation. The comparison group received the same acupuncture treatment. However, during treatment, they were told to simply focus their mind on their Dan Tian. All patients were treated with even supplementing even draining technique and needles were retained for 30 minutes. During acupuncture, all patients received supplemental inhaled oxygen. One treatment was given per day, five days per week, and one course of treatment consisted of six weeks of such therapy. In addition, members of the treatment group received cognitive behavioral therapy, while members of the comparison group did not. In issue #2, 2003 of Tian Jin Zhong Yi Yao (Tianjin Chinese Medicine & Medicinals), Dr. Cui Jin-bo of the An Ding Municipal Hospital in Tianjin, China published an article titled, “The Combined Treatment of Depressive Episodes with Acupuncture & Psychotherapy.” According to study by Dr. Cui “While acupuncture at these points was definitely effective for ameliorating depression, it was even more effective when combined with psychotherapy.” (Flaws TCM-Psychotherapy 2003: 2) My patient tried psychotherapy for 2 years, but without using TCM. I suggest him to do both at same time.
According to my research in Ze-lin Chen, M.D., A Comprehensive Guide to Chinese Herbal Medicine, manic-depressive psychosis is said as follow: “Depressive psychosis is characterized by alternating bouts of complete silence, incoherent speech and unprovoked laughter, while mania is typified by ravings, greatly increased activity, euphoria and delusions of grandeur. If these states alternate, the condition is known as manic-depressive psychosis or simply manic depression.” (Chen 92: 303)
“Irritability” (pitta dosha), “susceptibility to anger” (pitta dosha in mano vaha srotas and sadhaka pitta, along with liver fire), “a red complexion” (pitta dosha fire in the liver), “conjunctival congestion” (pitta-kapha dosha in alochaka pitta and the liver), “fixed staring” (pitta dosha in alochaka pitta and the liver), “frequent crying” (kapha dosha in mano vaha srotas), “restlessness” (vata or pitta dosha with rajas guna), “excessive aggressiveness which results in injury to others” (pitta dosha with tamas guna), “, greater-than-normal strength” (pitta-kapha dosha), “a red tongue” (pitta dosha – Giovanni Maciocia says “dark red with redder sides and tip, this definitely indicates that anger rather than sadness is the cause of the depression.” (Maciocia 95: 120) “with a greasy, yellow coating” (pitta dosha with ama [toxins] in the liver and heart) “and a wiry, slippery pulse are indicators of an ascent of phlegm-fire.” (vata pushing pitta or simply pitta pushing kapha in the liver) (Chen 92: 305) “Phlegm-Fire obstructs the Mind but it also agitates it. It therefore makes the person agitated” (pitta dosha), “restless and anxious” (vata dosha). “In some cases, the person may alternate between periods of depression and confusion (due to Phlegm)” (and due to kapha dosha) “and periods of abnormal elation, agitation and manic behavior (due to fire)” (due to pitta dosha). “In severe cases this leads to manic-depression. Chinese books always describe this condition as alternation of periods of severe depression (the depressive state called Dian1) and periods of manic behavior (the manic phase called Kuang2). The manic phase is usually described as shouting, scolding or hitting people, climbing mountains, taking off clothes” (Wu 85: 265) (all of the previous five are pitta dosha and have been manifested by my manic case study patient), “crying or laughing uncontrollably”. In Hua Tou’s 200 A.D. TCM classic Zhong Zang Jing (Master Hua’s Classic of the Central Viscera), he states that yang inversion causes “sudden congestion”, “red cheeks and vexation of the heat, a cloudy brain,” “fire-red eyes, burning heat of the whole body, performance of what is beyond normal conditions, climbing up heights to sing and laugh, running about disrobed, manic speech and confused talk”, “excessive agitation, incessantly drinking water, inflation and distention of the chest and diaphragm, abdominal and hypochondriac fullness and oppression,” “shouting and screaming. The pulse in yang inversion suggests survival if it feels strong whether pressure is applied or not, but death if it is expiring.” (Yang 93: 15-16) My manic case study patient has sometimes manifested this crying or laughing uncontrollably and had manifested most of the symptoms described above by Dr. Chen, Dr. Maciocia, and ancient TCM master Hua. “It is important to realize that, in practice, much milder versions of this condition appear fairly frequently and one should not always expect such violent symptomatology in order to diagnose this condition.” My manic case study patient has manifested them all fairly frequently at different times of his life. “Phlegm-Fire manifests with a Slippery and Rapid pulse with a Red-Swollen tongue with a sticky yellow coating and a Heat-crack in the midline.” Ayurveda calls this pitta dosha with ama (heating and mucous toxins blocking up the subtle channels of the heart and brain [mano vaha srotas]). (Maciocia 94: 226) (Maciocia 95: 163) (Wu 85: 265) It appears that more serious cases of manic-depression are clearly a mixture of all three doshas (vata, pitta, and kapha) disturbed by ama (toxic heat phlegm).
This “taking off clothes” (Wu 85: 265), “running about disrobed” (Yang 93: 15-16), and “tendency to become nude” (Lad 91) all seem to be common to the description of TCM and Ayurveda for the manic episodes of bipolar. My case study patient has reported to me that several times when he had “nervous breakdowns” over last 20 years, he tore off his clothes quickly and ran outside or jumped into cold stream-river or walked down the street nude with craziness or ran naked up onto roof of his house in cold weather fog to yell or sing out like crazy. It confirms this behavior as symptom of manic side of bipolar when it says in TCM Ming dynasty text Divinely Responding Classic (Shen Ying Jing from the Zhen Jiu Da Cheng) compiled by Yang Ji-zhou that one should needle “for enduring mania with climbing heights to sing and running about naked: Spirit Gate (Shen Men, Ht 7), Back Ravine (Hou Xi, SI 3), and Surging Yang (Chong Yang, St 42).” (Yang 94: 51)
Dr. Ze-Lin Chen (M.D. China) recommends Iron Filings Combination Decoction – called Sheng Tie Luo Yin in Mandarin (Sheng1 Tie3 Luo4 Yin4) (Bensky-Barolet 1990: 386)
(Chen 92: 305) Ingredients: Asparagus radix (Tian Men Dong) – Asparagus, 3g; Ophiopogonis rhizoma (Mai Meng Dong) – Ophiopogon, 3g; Fritillariae bulbus (Bei Mu) – Fritillaria, 3g; Arisaema cum bile (Dan Nan Xing) – Arisaema with bile, 1g; Citri exocarpium rubrum (Ju Hong) – Orange peel, 1g; Polygalae radix (Yuan Zhi) – Polygala, 1g; Acori rhizoma (Chang Pu) – Acorus[24], 1g; Forsythiae fructus (Lian Qiao) – Forsythia, 1g; Poria sclerotium (Fu Ling) – Hoelen, 1g; Poria cor (Fu Shen) – Fu-Shen, 1g (Chen 92: 305)
According to Giovanni Maciocia, the treatment principle for phlegm-heat harassing the mind is “Resolve Phlegm, open the orifices and calm the Mind.” (Maciocia 94: 240) (Wu 91: 256-257)
Acupuncture Treatment: ST40 Fenglong, P7 Daling, P6 Neiguan, P5 Jianshi, Du14 Dazhui, BL15 Xinshu. (Maciocia 94:226)
According to my research in Philippe Sionneau and Lu Gang’s textbooks The Treatment of Disease in TCM – Volume 1: Diseases of the Head and Face Including Mental / Emotional Disorders (Sionneau 96), the western term bipolar disorder (manic-depression) seems to match up with three TCM pattern categories:
Vexation and Agitation (Fan2 Zao4) – Annoyance due to a hot sensation in the chest (Sionneau 96: 207)
Irascibility (Shan4 Nu4) – Easily becoming incensed or having a hot-temper which is not under one’s conscious control. (Sionneau 96: 227)
Frequent Joy (Shan4 Xi2) – mental-emotional excitement or exultation (Sionneau 96: 233) (“psyched up”)
“Vexation here means annoyance due to a hot sensation in the chest. Agitation refers to a restless state of the limbs due to a hot sensation in them. The former is a subjective symptom, while the latter is an objective sign. Although they are different, they are usually considered one term (Fan Zao) since, in most cases, they occur in combination and share the same disease mechanisms. The vexation and agitation which signal a crisis in an extremely severe disease is not covered by the discussion” here. (Sionneau 96: 207) My case study patient has many years of frequent expression of both vexation (hot chest) and agitation (restless limbs).
“The invasion by wind cold” (vata dosha in Ayurveda) “is
often the causative factor in this pattern.
Such invasion may depress yang” (pitta in Ayurveda) “when it invades the
exterior. When yang is depressed, it
will transform into internal heat” (pitta dosha in Ayurveda). “Vexation and agitation” (pitta dosha) “will
then occur when this heat disturbs the heart spirit” (sadhaka pitta in
Ayurveda). (Sionneau 96:
207) In ancient master physician Hua Tou’s 200 A.D.
TCM classic Zhong Zang Jing (Master
Hua’s Classic of the Central Viscera), he states that “mania and frenzy…all
this arises out of wind.”[3] (Yang
93: 47) In Ayurveda, this is vata pushing pitta (wind
creating excess heat). Before he became vegetarian in 1997 (which
decreased his excessive internal fire – pitta dosha), my manic case study
patient had many years of often exposing himself to wind cold (vata dosha) when
walking around in shorts and t-shirt in windy-cold (vata dosha) foggy
“Vexation and agitation” (pitta dosha), “generalized pain”
(vata dosha), “fever” (pitta dosha), “aversion to cold” (vata dosha), “absence
of sweating” (vata dosha), “headache” (vata dosha), “slight thirst” (vata
dosha), thin, yellowish-white tongue fur” (pitta yellow -kapha white), and a
floating, tight, rapid pulse” (pitta dosha).
(Sionneau 96: 209) My case study patient had “everyday vexation
and agitation”, many pain, sometimes night-time fever (around
“Resolve the exterior and scatter cold” (soothe vata dosha), “clear heat and eliminate vexation and agitation.” (soothe pitta dosha) (Sionneau 96: 209)
According to Bob Flaws, “Psychiatric disorders are often categorized as ‘knotty, difficult to treat diseases’ in Chinese medicine. The main modality and standard of care in professional Chinese medicine for the treatment of psychiatric disorders is the internal administration of Chinese medicinals. However, as Ding De-zheng points out in an article titled, ‘Knowledge Based on Experience of the Acupuncture Treatment of Psychiatric Disorders,’ the combination of acupuncture with such internally administered medicinals is often able to achieve an even better effect than internally administered Chinese medicinals alone.”[25] (Flaws-Ding 2001) Thus, we shall always discuss both the herbal and the acupuncture treatments together.
Shao Fu (Ht 8) Clears the heart and eliminates vexation
Zhi Zheng (SI 7) Together, these points expel wind and
scatter cold,
Feng Men (Bl 12) resolve the exterior and eliminate
vexation
He Gu (LI 4) Together, these points clear internal heat
and
Qu Chi (LI 11) resolve the exterior (Sionneau 96: 207)
“Modified Da Qing Long Tang (Great Blue Dragon Decoction)
Ingredients: Uncooked Herba Ephedrae (Ma Huang), 9g; uncooked Ramulus Cinnamomi (Gui Zhi), 6 g; mix-fried Radix Glycyrrhizae (Zhi Gan Cao), 5g; uncooked Semen Pruni Armeniacae (Xing Ren), 6g; uncooked Gypsum Fibrosum (Shi Gao), 25g; uncooked Rhizoma Zingiberis (Sheng Jiang), 3g; Fructus Zizyphi Jujubae (Da Zao), 3 fruits; clear Semen Praeparatus Sojae (Dan Dou Chi), 9g.” (Sionneau 96: 207-208)
My case study patient would sometimes cook soups with licorice and jujube fruits. Ayurveda used licorice (called Yasthi madhu in Sanskrit) along with other herbs like Brahmi (Centella asiatica) to treat manic-depression when there is both vata and pitta doshas disturbed.
“In externally contracted warm diseases” (pitta dosha), “if the evils are not eliminated and remain in the body, they may enter the yang ming channels and struggle there. ‘The yang ming channel shared plenty of qi and blood.’ Therefore, a fight in the yang ming will make the heat worse. In addition, heat evils can easily bind with the stool, causing blockage of the bowel qi” (perhaps pitta blocking apana vata) “and also add much heat. When this heat disturbs the heart spirit” (sadhaka pitta in Ayurveda), “vexation and agitation occur.” (Sionneau 96: 207) There is no clear Ayurvedic equivalent for yang ming.
“Vexation and agitation” (pitta dosha), high fever ” (pitta dosha due to ama [toxins]), “sweating” (pitta dosha), “coarse breathing, thirst” (vata or pitta dosha), “constipation or dry stools” (vata dosha) “with fluid defecation”, “abdominal fullness with palpable dry stools” (vata dosha), “pain in the abdomen exacerbated by pressure” (pitta dosha), “in severe cases, delirium” (vata dosha), “dry, yellow” (vata-pitta) or “dry, black tongue fur” (vata dosha), and a surging, large, or deep, replete pulse.” (Sionneau 96: 210) My case study patient has had high fever only two or three times in his adult life. He sweat a lot (pitta dosha), is often thirsty, but has almost never in life had constipation or dry stool. He tend toward loose stools (pitta dosha) for more than 7 years. He rarely has abdominal pain, has only once had delirium (as a child). He rarely has dry tongue (vata dosha), but most often has greasy yellow tongue fur (pitta dosha). So this pattern doesn’t really apply to his manic-depression.
“Clear heat, engender fluids, and greatly precipitate heat bind.” (Sionneau 96: 210)
In Ayurveda this is called “pitta soothing, not vata disturbing”.
He Gu (LI 4) Together, these point clear heat in the yang
Nei Ting (St 44) ming.
Zhi Gou (TB 6) Together, these points free the
stool (but are less
Shang Ju Xu (St 37) effective than internally administered
medicinals).
Wei Shu (Bl 21) Together, these points engender
fluids
Ran Gu (Ki 2) (Sionneau 96: 210)
“For heat in the yang ming channel: Modified Bai Hu Tang (White Tiger Decoction)
Ingredients: Uncooked Gypsum Firbrosum (Shi Gao), 25g; uncooked Rhizoma Anemarrhenae (Zhi Mu), 9g; Radix Glycyrrhizae (Gan Cao), 6g; Semen Oryzae Sativae (Geng Mi), 9g; clear Semen Praeparatus Sojae (Dan Dou Chi), 6g; stir-fried Fructus Gardeniae Jasminoidis (Zhi Zi), 6g.” (Sionneau 96: 210-211)
“For heat in the yang mind bowel: Da Chang Qi Tang (Major Order the Qi Decoction)
Ingredients: Uncooked Radix et Rhizoma Rhei (Da Huang), 9g; Mirabilitum (Mang Xiao), 6g; ginger-processed Cortex Magnoliae Officinalis (Hou Po), 6g; bran stir-fried Fructus Immaturus Aurantii (Zhi Shi), 6g.” (Sionneau 96: 211)
“If an evil qi has not been eliminated but the righteous qi has become vacuous” (vata dosha), evils and the righteous qi will fight in-between the exterior and interior and thus produce heat which will bind in the shao yang channel. When this heat disturbs the heart spirit, it causes vexation and agitation.” (Sionneau 96: 208) In Ayurveda, there seems to be no close equivalent to this.
“Vexation and agitation” (pitta dosha), “alternating chills” (vata dosha) “and fever” (pitta dosha due to ama [toxins]), “chest and lateral costal fullness and oppression exacerbated by lying on one’s side”, “susceptibility to fright” (vata dosha), “cumbersome limbs” (vata dosha), “a bitter taste in the mouth” (pitta dosha), “inhibited urination” (vata dosha), “and a wiry pulse” (vata dosha). (Sionneau 96: 211) With my case study patient, out of all of the above symptoms, he generally only had a bitter taste in the mouth.
“Harmonize the shao yang, clear heat” (soothe pitta), “and eliminate vexation” (soothe pitta). (Sionneau 96: 211) With my case study patient, my main treatment principle has always been to clear heat. In Ayurveda, this is the best way to decrease excess pitta that leads to manic episodes.
Qi Men (Liv 14) Harmonizes the shao yang
Da Zhui (GV 14) Together, these points clear heat and
eliminate
Jian Shi (Per 5) vexation.
Zu Lin Qi (GB 41) Leads the heat, water, and qi in the chest and lateral costal region downward in order to relieve the fullness and oppression. It also disinhibits the urination.” (Sionneau 96: 211)
Summary Treatments for Phlegm-Heat Mania According to ACCHS Professors
My audio-taped research interviews were with TCM Doctors B.K. Chin, W. Chung, Y.M. Fang, H.H. Hsiao, D.M. Li, M.L.D. Liang, H.J. Wang, L. Wang, S. Woodley, J. Yeh, and W.Y. Zhu. As a sample of the variety of answers, I will cite one or two particular teacher’s answers. For those who interested, I can make available my original audio recordings of the professor TCM doctor interviews on CD for you listening to. To save space, I decide to summarize all of the teacher’s answers as follows:
Survey for TCM Research - Manic Disorder (few Depressive Episodes)
Treatment Principle: Clear Fire, Eliminate Phlegm
Professor/Teacher are all either M.D. (
1.
What are the top
2.
What are the top
3.
What are the top
moxibustion points? (or is it contraindicated for mania) Dr. Hsiao says: No. Dr. Chung says: No. Dr. Fang says: No. J. Horowitz says: For loose stool
moxibustion on Ren8; for cold hands and feet use moxibustion on K1 and P8. In general, most doctors said that moxa is
not recommended for bi-polar with mostly manic episodes since it increase heat
too much.
4.
What are the top
cupping points/meridians? (or is it contraindicated for mania) Dr. Hsiao says: No.
Dr. Chung says: No. Dr. Fang
says: Heart, Liver and Kidney, Small Intestine meridians. J. Horowitz says: For mania do cupping on
UB15 and UB13, UB20. In general, most
doctors said that cupping is not useful for bi-polar with mostly manic
episodes.
5.
What are the
scraping (gua sha) points/meridians? (or
is it contraindicated for mania) Dr.
Hsiao says: Hua Tuo Jia Ji (on back). Dr. Chung says: No. Dr. Chung says: Same as above. Most
said no.
6.
What are the top
5 to 10 bleeding points? (or is it
contraindicated for mania) Tip of each
of the ten fingers (shi shen) should be bled is what many teachers said. Others, say to bleed the ear apex. Dr. Li-Chun Huang, M.D. (
7.
What is your
recommended herbal patent medicine tablets (pian-wan)? Dr. Horowitz, Dr. Liang, Dr. Wang and Dr.
Bensky recommended three possible formulas: Jia Wei Shao Yao San (Bensky-Barolet 1990: 148) and Bai He He Huan Pi and Gan Mai Da Zao Tang (Bensky-Barolet 1990: 383). Dr. Hsiao,
Dr. Horowitz, Dr. Wu and Dr. Bensky recommended Wen Dan Tang Pian. (Wu 85: 265) (Bensky-Barolet
1990: 435) Dr. Chin and Dr. Liang recommend Mong Shi Gun Tang Wan (Wu 85: 265). Also
referred to as Gun3 Tan2 Wan2, “drains fire and drives out phlegm” and contains
Duan Meng Shi 30g, Da Huang 240g, Huang Qin 240g, Chen Xiang 15g” (Bensky-Barolet 1990: 424) Dr. Chin, Dr.
Fang, and Dr. Liang recommend Di Tan Tang.
“Di2 Tan2 Tang1 – Guide Out the
Phlegm Decoction” (Wu
85: 265) (Bensky-Barolet 1990: 424) The Qing
Dynasty Dr. Liu Yi-Ren, author of the classic Yi Xue Chuan Xin Lu (The
Heart Transmission of Medicine) says that mania (with joy or excitation) “requires
clearing the heart and nurturing the spirit with Ning Zhi Hua Tan Tang (Calm Mind & Transform Phlegm Decoction as
the ruling (formula). Mania” (with anger) “requires dispelling wind and
eliminating heat with Fang Feng Tong
Sheng San (Notopterygium Sage-communicated Powder) as the ruling
(formula).” (Liu 97:
138-139) (Bensky-Barolet 1990: 58)
8. What is your recommended customized bulk herb decoction formula? Same as above.
Dr.
Wu of Zhiang Xi Publishing recommends in the Chinese Mandarin textbook, to take
the decoction of Xie4 Xin1 Tang1 for phlegm-fire with mental disturbances. (Wu 91: 256-257) Bensky says it
contains “Da Huang 6g, Huang Lian 3g, and Huang Qin 3g.” (Bensky-Barolet 1990: 79) Dr. Fang
says: Add Shen Tie Luo and Ci Shi to the standard Di Tan Tang formula. (Wu 85: 265) (Bensky-Barolet
1990: 424)
9.
If you had to use
a simple two herb or four herb combination using classical “dui
Philippe Sionneau in his book Dui Yao –
The Art of Combining Chinese Medicinals says to use Long Gu (Os Draconis)
and Mu Li (Concha Ostreae) to “calm the liver and subdue yang, quiet the
spirit” to help with “vexation and agitation, insomnia, dizziness, vertigo,
photophobia, and tinnitus due to liver yang hyperactivity harassing the spirit”
with “chronic diarrhea” and “excessive perspiration due to vacuity.” (Sionneau 97: 111-112) My manic case study patient has
all of these symptoms. Ayurveda also
uses conch shell as a purified ash called Shanka
Bhasma for similar reasons.
Dr. Li and Dr Chin recommend the dui
10.
What are the best
recommended foods to treat this manic-disorder?
Dr. Fang says: Hei Mu Ar (Black
Wood Ears), Lian Oh (Lotus Root Stalks), Ku Gua (Bitter Melon). Bai He and Mai Dong and Shan
11. What the recommended flavors to enjoy in order to better treat this manic-disorder? (sweet, sour, salty, bitter, pungent, astringent, bland) Dr. Fang says: Bitter and Pungent. Most doctors say bitter and bland. Ayurveda, Yoga, Buddhism and Tibetan Medicine strongly agree with bitter, bland, astringent (dry) being the best flavors.
12.
Do you recommend
that such a manic disorder patient be vegetarian to improve their condition?
Dr. Chung says: Yes, there will be less anger if one is vegetarian. 9 TCM doctors said it is not necessary, but 3
doctors recommend vegetarianism strongly: Dr. Zhu, Dr. Wang, Dr. Chung. Ayurveda, Yoga, most Mahayana Buddhism say that
it is vital to be vegetarian, but not vegan if you have manic angry episodes. Being
vegan however will help decrease the mucous of the phlegm-fire.
13.
What are worst
foods that such a manic disorder patient should avoid in order to not worsen
their condition? Dr. Chung says: Spicy
foods, coffee and alcohol. Dr. Fang
says: Hot and Spicy foods, especially avoid goat meat and beef. Most of the doctors say avoid spicy.
Ayurveda agrees.
14.
What are the
recommended flavors to avoid in order to better treat this manic-disorder?
(sweet, sour, salty, bitter, pungent, astringent, bland) Most of the TCM doctors say avoid pungent. Ayurveda, Buddhism, Yoga and Tibetan Medicine
say avoid especially pungent, then excess salty, and excess sour.
15.
What are the
recommend vitamin-mineral-enzyme or “nutriceutical” (nutritional supplements)
to use in order to better treat this manic-disorder? Dr. Fang says: Magnesium. Most TCM doctors are not sure.
16.
What types of
exercise would benefit such a manic-disorder patient? Performed at what best time of the day? Dr. Chung says: Qi Gong, Tai Chi and Yoga
in the morning. Go to bed at
17.
Is meditation
important in treatment of such a manic-disorder patient? Dr. Chung says: Yes. Dr. Fang says: It depends. Yes 9 doctors – Dr. Hsiao, Dr. Li, Dr.
Liang, Dr. Chin, Dr. Woodley, Dr. Horowitz, Dr. L. Wang, Dr. Cheng, Dr. Zhu –
all say it is important. Ayurveda, Yoga,
Buddhism and Tibetan Medicine says that while it is important as a Christian,
Muslim, Jew, or Buddhist (world’s 4 major religions) to chant mantras or pray
regularly, in these hectic modern times, especially if one is manic, “it is
vital for mental-physical health to meditate silently morning and evening for
at least 20 minutes. Meditate in the way you are accustomed, or silently walk
in nature or practice counting your breath for 108x or try mantra meditation,
chant 108x ‘Om Kshanti – Shanti Paramita’ (Perfection of Patience and Peace) or
‘Om Namo Amitabha’ or ‘E Na Li Pi She Ti’ or ‘She Dan Dwo Bwo Da La’ or ‘Om
Mani Padme Hum’. Such auspicious mantra meditation combined with silent Vipassana
or Ch’an meditation brings healing, protection, balance, peace and
accomplishment into your life and the world.”
18.
What, if any, is
the appropriate massage therapy for such a manic-disorder patient? Most TCM doctors say no. “Ayurveda says to daily apply oil to the head
and body (abhyanga). This rubbing warm oil over the head and body
is called snehana (which means love
in Sanskrit). Gentle, daily oil massage of the scalp can bring happiness, as
well as prevent headache, baldness, graying, and receding hairline (all due to
pitta). Oiling your body before bedtime will help induce sound sleep and keep
the skin soft. For pitta manic use Pitta Oil, Neem Oil, Bakuchi Oil, Maha
Ganesh Oil or Bhringaraj Oil diluted with warm sunflower or coconut oil.”
19.
What is your
recommended method and area for tui na massage? Dr. Chung says: No. Dr. Fang says: No. Most say no.
20.
What, if any, is
the appropriate color therapy for such a manic-disorder patient? Dr. Hsiao says: .
Dr. Chung says: he is not sure. Dr. Fang says: Blue. 3 Doctors say Blue – Dr. Zhu, Dr. Hsiao, Dr.
Fang. Ayurveda, Yoga, Buddhism and
Tibetan Medicine say that it is most soothing to walk, play, work in natural
environs where blue (water) and green (trees, plants, forest) abounds, wear
clothing with predominance of blue, green, purple, and indigo.
21. What, if any, is the appropriate aroma therapy for such a manic-disorder patient? Dr. Hsiao says: . Dr. Chung says: he is not sure. Dr. Fang says: Light smells. Most say not sure. Ayurveda, Buddhism, and Yoga says to balance anger and mania with sweet, cool, and dry scents such as Sandalwood, Lavender, Rose, Jasmine, Lotus, Patchouli and Vetivert. Wear or vaporize essential oils such as: (may be placed on the points above or / and on the soles of feet and scalp).[26]
22. What is the rate of recovery of the patient after 3, 6, 9, 12 months? Dr. Chung says: Patient needs to change their lifestyle and realize that everything is created by the mind alone. Hard to treat and hard to predict. Dr. Fang says: Patient needs to change their lifestyle. Curable but takes time – must be patient. Some doctors recommend combing with Western drug medicine and Western psychotherapy. They all say it depends on how long they have had the disease and on how much they are willing and able to follow the TCM doctors advice and to make major changes in their lifestyles including sleep habits, diet. Also in my research I discover that the person should not have too frequent sexual activity since this weakens the kidneys, liver and leads to liver qi deficiency (due to the kidney not nourishing the liver) with liver-fire-rising. Ayurveda, Tibetan Medicine, Yoga and Buddhism say it is curable over time with the Four Unlimited Minds of kindness, compassion, joy, equanimity – renunciation; and the Six Perfections of generosity, precepts (no killing, no stealing, no sexual misconduct, no lying, no taking drugs-alcohol-cigarettes), patience, vigor, mindfulness (meditation) and wisdom. Herbs are only 5% of cure for mania. Balanced sleep, diet, sex (not to frequent), and calm lifestyle are most important. “Pranayama – Yogic Breathing is important for recovery. After exercise, sit quietly and do some deep breathing exercises as follows: 12 alternate nostril breaths to calm and balance vata, followed by 16 cooling shitali breaths (curling up your tongue lengthwise and breathing through it) for pitta heat, irritation, inflammation and anger. Ayurveda also recommend for mania to use Nasal Drops (Nasya) for Good Prana – Qi. Put 3-5 drops of warm ghee or brahmi ghee into each nostril in the morning to help to lubricate the nose, clean the sinuses, and improve voice, vision, memory, and mental clarity. Our nose is the door to the brain, so nose drops nourish prana-qi and bring intelligence. For pitta mania: brahmi ghee for anger and migraines, sunflower or coconut oil.”
“According to Dr. Ding[27], adolescent schizophrenia”, which is similar to the manic-episodes of my manic case study patient, “are mostly due to phlegm fire harassing and causing chaos to the spirit brilliance, thus leading to manic and chaotic behavior.” This is an accurate diagnosis of my manic case study patient. According to Dr. Ze-lin Chen, M.D. (China), he recommends needling Da Zui (GV 14), Feng Fu (GV 16), Shui Gou (CV 26), Nei Guan [a.k.a. Ren Zhong] (P6), and Feng Long (S 40). “For patients with phlegm fire pattern mania and chaotic behavior, besides internally administering appropriate Chinese medicinals to transform phlegm, drain fire, open the orifices, and quiet the spirit, Dr. Ding needles Tong Li and Xian Gu as well as Xin Shu (Bl 15), Wei Shu (Bl 21), Feng Long (St 40), Shao Chong (Ht 9), and Li Dui (St 45), all with draining technique and strong stimulation. Dr. Ding needles one time every day, and, typically, after 15 days, the mania and chaotic behavior can mostly be brought under control. This combination of points for this condition seems to be a traditional Ding family protocol, since Dr. Ding quotes two other Dings regarding this combination’s ability to treat phlegm fire manic conditions.” (Flaws-Ding 2001)
“Dr. Ding recommends the combination of Tai Chong and Feng Fu for the treatment of manic anger, cursing, vexation, agitation, and impetuosity due to liver fire.” (Flaws-Ding 2001) My case study patient has frequently manifested these symptoms now for more than 10 years. “Tai Chong is the source point on the foot jue yin liver channel. Needling it can repress the liver and drain fire, while needling Feng Fu can settle the spirit and stabilize mania. Dr. Ding commonly combines these two main points with Da Dun (Liv 1), Gan Shu (Bl 18), Li Gou (Liv 5), and Qu Quan (Liv 8), all with draining technique and strong stimulation, along with internally administered Chinese medicinals, giving one acupuncture treatment per day. According to Dr. Ding, typically, after 20 days, the mania and anger can be greatly reduced and eliminated in approximately 30 days.” (Flaws-Ding 2001)
“Dr. Ding thinks the combination of Yin Xi and Ear Shen Men is especially good for the treatment of manic euphoria, laughing and singing without limit, excessive stirring, heart vexation, and insomnia, due to heart fire.” (Flaws-Ding 2001) My case study patient will alternate between feeling he can take on anything and is, as he says, “psyched up”, with frequent joking around and laughter, and then suddenly feeling frustrated and volcanically angry at not being able to meet his own perfectionistic goals. He doesn’t “laugh and sing without limit”, but does have “excessive stirring, heart vexation, and insomnia, due to heart fire.” According to Dr. Ding, “Yin Xi is the cleft point on the hand shao yin heart channel, and needling it can drain heart fire. Ear Shen Men is very effective for settling the heart and quieting the spirit. Besides appropriate internally administered Chinese medicinals, Dr. Ding commonly combines these two points with Xin Shu (Bl 15), Ling Dao (Ht 4), Shao Hai (Ht 3), and Ren Zhong (Gv 26), all with draining technique and strong stimulation. Each day, Dr. Ding needles 1-2 times. Dr. Ding says that, typically, manic euphoria can be greatly reduced after 18 days and completely eliminated after 30.” (Flaws-Ding 2001)
“In his conclusion, Dr. Ding says that, if one is able to use acupuncture as an adjunctive treatment in psychiatric disorders, it is not so difficult to get a marked treatment effect in such otherwise commonly difficult to treat disorders.” (Flaws-Ding 2001)
In Hua Tou’s 200 A.D. TCM classic Zhong Zang Jing (Master Hua’s Classic of the Central Viscera), he states that it is curable if a person only has manic raving “due to lung qi ascending without descending, it burns the lungs” and “injures the lungs due to heat”. But he says that “this is incurable if (this disease) is transformed from the lungs into the blood.” (Yang 93: 89-90) He also says that although normally “manic raving and confused speech” can “(indicate) death but are not fatal in a hot disease. (Yang 93: 159, 34)
“In most cases it is caused by anger that injures the Liver, leading to its failure in dispersing. The stagnated Qi transforms into fire, which evaporates the body fluid to produce phlegm fire. The phlegm fire pervertedly rushes upward and disturbs the mind.”[28] This describes my case study manic-depressive patient perfectly. The Chinese Acupuncture and Moxibustion treatise goes on to say that manic-depression has a hereditary trend and often a positive family history. Again, in my case study patient, this is true – his father and both of his older brother and sister have long histories of manic-depression.
Main manifestations:[29] Sudden onset - this is typical of Pitta which is hot, sharp and fast in nature. Irritability - again a constitutional psychological trait of Pitta out of balance. Irritability is “fan” in Mandarin TCM terms[30] Being easy to anger – Pitta. Insomnia - this would be the "hot" excessive Yang type of Pitta-style insomnia. Loss of appetite. Followed by excessive motor activity with increased energy and violent behaviors. Yellow, sticky tongue coating - Yellow tongue shows Pitta excess. String-taut, rolling and rapid pulse.
Analysis: [31] Anger damages the Liver - Ayurveda, like TCM, states the same thing. The Liver fire flares up and agitates the Phlegm heat of Yangming to disturb the mind. Therefore, the patient is irritable, unable to fall asleep and easy to anger. Violent behaviors take place because of disturbance of the mind by Phlegm heat. The limbs are the foundations of all Yang actions. Preponderant Yang makes the limbs more energetic, thus the physical strength and motor activity are increased. The combination of Phlegm and heat, leads to yellow sticky tongue, string-taut, rolling and rapid pulse.
Even movement is applied to the points of the Heart and Liver Meridians to soothe the Liver, calm the Heart and dissolve the Phlegm. Acupuncture Prescription:[33] Xinshu (B15), Ganshu (B18), Pishu (B20), Shenmen (H7), Fenglong (S40). Explanation:[34] This condition is caused by the stagnation of Phlegm and Qi, which injures the Heart, Liver and Spleen. Giovanni Maciocia says in his tongue diagnosis book that you can detect the phlegm-heat stickiness that causes manic and loose stools by examining the tongue. He says this is “spleen-qi deficiency, which is the basis for the formation of phlegm” that causes manic-depression and loose-stool. He says, “the pale color of the tongue body and tooth marks indicated Spleen qi deficiency.” (Maciocia 95: 163) My manic case study patient often has these tongue symptoms like the color plate #46 in his book, but with a yellow thick coating. Xinshu (b15) is used to clear the Heart. Ganshu (B18) to remove the Liver stagnation. Pishu (B20) to promote the Spleen and Qi circulation. Shenmen (H7) and Fanglong (S40) to dissolve the Phlegm for calming the mind.
Reducing is applied to the main points of the Du Meridian and Pericardium Meridian of Hand Jueyin to calm the Heart, ease the mind, reduce heat and dissolve the Phlegm. Acupuncture Prescription:[36] Dazhui (DU14), Fengfu (DU16), Shuigou (DU26), Neiguan (P6), Fenglong (S40) Supplementary Points: [37] Mania with extreme heat: Prick the twelve Jing (Well) points on the hand (L11, H9, P9, LI1, SJ1, SI1) to bleeding for reducing heat. This is similar to the Ayurvedic Pancha Karma (The five treatment methods) concept of therapeutic bleeding to reduce Fire and Water element (Pitta) excess. Explanation:[38] This condition is caused by the stagnation of Phlegm and Qi, which injures the Heart.
“Sudden onset, irritability, easily angered, flushed face, blood-shot eyes, headache, insomnia followed by excessive motor activity and unusual strength, mania, restlessness, constantly abusive and violent behavior, climbing up to a high place and singing, running around with the body inappropriately exposed. Tongue: Red with yellow greasy coating. Pulse: Wiry, slippery and rapid pulse.” (Stone 97)
For Manic Psychosis: Purge fire, remove phlegm tranquilizing the mind and calming the Shen.
According to the 200 A.D. Sanskrit classic Sushruta Samhita, mania involves: “Excessive thirst, perspiration, burning sensation, voracious eating, insomnia, desire for shade, cold, wind and walks on the banks (of rivers or tanks), fits of anger, fancying fire in cold water and fancied sight of stars in the heavens in the day are the symptoms which characterize the Pittaja (Pitta) type.”[41]
As a rule Western drug therapies mitigate symptoms, oftentimes without ameliorating the underlying ailment. We will now discuss the various drug therapies used by modern allopathic medicine along with the potentially safer herbs (certainly more widely time-tested - over several hundred to several thousand years) of Traditional Chinese Medicine and Ayurveda. One of the many problems with antidepressants, sedatives, and tranquilizers is that pregnant women taking them can cause the fetus to have hearing loss, abnormal limbs and even death.[42] Most drug therapies work by adjusting the delicate neurotransmitter balance in the brain. “Our brains consist of about one billion neurons, all packed into the compact cranial case we carry around on our shoulders. These neurons communicate constantly with one another via electrochemical signals transmitted across their synapses by neurotransmitters.”[43] “Neurotransmitters are nerve-signaling compounds released by individual nerve cells.”[44]
“Altered health maintenance; altered nutrition: less than body requirements; altered though processes; chronic low self-esteem; impaired home maintenance management; impaired physical mobility; impaired verbal communication; ineffective denial; ineffective individual coping; risk for violence: self-directed or directed at others; self-care deficit; sensory or perceptual alterations; sexual dysfunction; sleep pattern disturbance; social isolation.” (Eckman-97: 49)
“Remember the manic patient’s physical needs. Encourage him to eat; he may jump up and walk around the room after every mouthful but will sit down again if you remind him. Offer high-calorie finger foods, sandwiches, and cheese and crackers to supplement his diet if he can’t remain seated long enough to complete a meal. Suggest short daytime naps, and help with personal hygiene. As the patient’s symptoms subside, encourage him to assume responsibility for personal care. Provide emotional support, maintain a calm environment, and set realistic goals for behavior. Provide diversional activities suited to a short attention span; firmly discourage the patient if he tries to overextend himself. When necessary, reorient the patient to reality, tactfully divert conversations when they become intimately involved with other patients or staff members. In a calm, clear, and self-confident manner, set limits for the manic patient’s demanding, hyperactive, manipulative, and acting-out behaviors. Setting limits lets the patient know that you’ll provide security and protection by refusing inappropriate and possibly harmful requests. Avoid leaving an opening for the patient to test or argue. Listen to requests attentively and with a neutral attitude, but avoid power struggles if the patient tries to put you on the spot for an immediate answer. Explain that you’ll seriously consider the request and will respond later. Collaborate with other staff members to provide consistent responses to the patient’s manipulations or acting out. Watch for early signs of frustration (when the patient’s anger escalates from verbal threats to hitting an object). Tell the patient firmly that threats and hitting are unacceptable and that these behaviors show that he needs help to control his behavior. Then tell him that the staff will help him move to a quiet area and will help him control his behavior so he won’t hurt himself or others. Staff members who have practiced as a team can work effectively to prevent acting-out behavior or to remove and confine the patient.” (Eckman-97: 49) “Alert the staff team promptly when acting out behavior escalates. It is safer to have help available before you need it than to try controlling an anxious or frightened patient by yourself. Once the incident is over and the patient is calm and in control, discuss his feelings with him and other suggestions to prevent recurrence.” (Eckman-97: 50)
Lithium salts have been confirmed capable in the therapy of bipolar disorders like manic-depression.[45] Mood swings like manic are caused by changes in levels of a neurotransmitter called norepinephrine. “An excess causes elation and a deficiency causes depression. Lithium salts seem to have the ability to control both mania and depression and to control mood swings. Lithium carbonate has been used for 30 years in treatment of manic-depressives. The reason for its action is likely tied to the electrical balance because it seems to regulate both an excess and a deficiency of norepinephrine.”[46]
|
Side effects of commonly prescribed mood-stabilizers |
|
|
Medication (brand name) |
Common side effects |
|
Lithium carbonate (Eskalith) |
Nausea, increased urination, thirst, hand tremor, GI distress (slurred speech, confusion when toxic) |
“If the patient is taking lithium, teach him and his family to discontinue the drug and notify the doctor if signs of toxicity, such as diarrhea, abdominal cramps, vomiting, unsteadiness, drowsiness, muscle weakness, polyuria and tremors occur.” (Eckman-97: 50) “Many patients do not like taking lithium, because it reduces depression but also reduces the ‘high’ or heightened mood elevation.” (Gaeddert 94: 161) “Advise the patient to take lithium with food or after meals to avoid stomach upset. Because restricting sodium intake increases lithium toxicity, instruct the patient to maintain a normal diet and normal salt and water intake. Lithium may impair mental and physical function; caution against driving or operating dangerous equipment while taking the drug.” (Eckman-97: 50)
“In acupuncture psychologists would have a powerful weapon with which to treat their patients in a rational manner instead of rolling tranquilizers down their throats, passing electric currents through their brains, or discussing those parts of their sex life which they would rather forget.”[47]
Note: “The use of acupuncture in the treatment of mental disorders is a new area of exploration. Chinese doctors believe that acupuncture can be effective to a certain extent. But because there are as yet no published reports, it is difficult to assess its true value, or to generalize about what kinds of disorders will respond well to acupuncture treatment. It is, however, agreed that acupuncture should be used in conjunction with other therapies, such as counseling and special education.”[48] This having been said, it is important to realize that acupuncture is only a small part of the tools at hand to a Traditional Chinese Medicine doctor.
As can be seen from my comparisons of Western medicine, Traditional Chinese and East Indian Ayurvedic models for understanding mania disorder, there are connections, both obvious and not so obviously between the three models. This is not surprising me, because Traditional Chinese Medicine and Ayurveda are both very much sciences, improved over several thousand years. Body-brain chemistry, and the ways the harmony of that chemistry are kept up and brought back to health if that harmony is lost, is one process, whether East or West. To quote J. Krishnamurti, the great world citizen philosopher, “Thought is thought. There is no Eastern or Western thought. Truth is a pathless land.” (Krishnamurti:92) In Buddhism it is said that there are 84,000 “Dharma doors” (Fa3 Men2) or ways to healing sickness and sufferings. No one medical system has the solutions in all cases of a particular disease. In other words, sometimes you can use the path (Dao4) of TCM to heal mania, sometimes Ayurveda works, sometimes Western psychotherapy or pharmaceuticals; other times meditation, precepts, morality, vows and Buddha Dharma can work miracles, for others the Tao or maybe Christian, Muslim, or Jewish religions path can make healing. I believe that the challenge of combination Western medicine – including nutrition and psychology – with Traditional Chinese Medicine and Ayurveda is “to graft the various branches of their respective theories and practices and develop a hybrid tree of health, longevity, and spiritual development that produces far sweeter fruits than either one could possibly yield alone.”[49] In treating psychological disorders like mania, we must not use only a worldly, mechanical or non-spiritual view of the world and the “dis-ease”. All of the psychological symptoms discussed in my paper have specific physical symptoms associated with them. And although psychological disorders are normally seen as separate and different from physical situations in Western medicine; Ayurveda and TCM identify them, as highly individualized constitutional (vata-pitta-kapha doshic) and TCM “5 Element - Yin/Yang - Zang Fu organ[5]” imbalances and treats them appropriately.
1.
Bensky,
D., Barolet, R.,
compilers and translators, Chinese Herbal
Medicine – Formulas and Strategies,
2.
Bertschinger, R., Dip.Ac (
4.
Bond,
T., and Coon, D., Mastery Study Guide to
Accompany Introduction to Psychology - Exploration and Application, 7th
ed.,
5.
Breggin,
P.R., Electroshock: Its brain disabling
effects,
6.
Breggin,
P.R., Toxic Psychiatry,
8.
Chen,
Ze-lin, M.D. (
10.
Clifford,
T., Tibetan Buddhist Medicine and
Psychiatry - The Diamond Healing,
14. Eckman, M, Priff, N, Diseases, 2nd
ed., Springhouse,
17.
Fan,
W.J.W., MD, A
Manual of Chinese Herbal Medicine - Principles and Practice for Easy Reference,
18. Flaws, Bob, Dipl. Ac. & C.H., FNAAOM. “Thoughts on the
Integration of Chinese Medicine &
19. Flaws, Bob, Dipl. Ac. & C.H., FNAAOM. “Appendix: Common Side
Effects of Western Psychiatric Medications”, Chinese Medical Psychiatry Website, (2000): 2 par. Online.
Available: http://www.chinesemedicalpsychiatry.com/resources/resources_appendix.html
20. Flaws, Bob, Dipl. Ac. & C.H., FNAAOM, abstracter and
translator, “The Combined Effect of Acupuncture & Psychotherapy on
Depressive Episodes.” Chinese Medical
Psychiatry Website, (2003) : 1 par. Online. Available: http://www.chinesemedicalpsychiatry.com/articles/acu_psycho_depression.pdf.
21. Flaws, Bob, Dipl. Ac. & C.H., FNAAOM, “Ding De-zheng’s
Acupuncture Treatment of Psychiatric Disorders.” Chinese Medical Psychiatry
Website, (2001) : 3 par. Online. Available: http://www.chinesemedicalpsychiatry.com/articles/article_ding_ac_treat.html.
22.
Fugh-Berman,
A., MD, "The history of hypnosis," in
Alternative Medicine: What Works - A Comprehensive, Easy-to-Read Review of the
Scientific Evidence, Pro and Con,
23. Gaeddert, Andrew, Chinese Herbs in the Western Clinic – A Guide to Prepared Herbal
Formulas Indexed by Western Disorder and Supported by Case Studies,
26.
Holmes,
D.S., Abnormal Psychology,
27.
Hua,
Hsuan, Venerable Chan Buddhist Master, Source: A Bookmark from the City of Ten
Thousand Buddhas,
28. Hua, Hsuan, Venerable Buddhist Tripitaka and Chan Master, commentary, The Shurangama Sutra – Volume Eight: The Fifty Skandha-Demon States – A Simple Explanation by the Venerable Master Hsuan Hua, “The Feeling Skandha” Chapter, publisher and translator Burlingame, California: Buddhist Text Translation Society, Dharma Realm Buddhist University, Dharma Realm Buddhist Association, www.BTTSOnline.org, 1st ed. 1996, 2nd ed., 2002.
33.
Kessler,
R.C., et al., "Lifetime and 12-month prevalence of DSM-III-R psychiatric
disorders in the
34. Kleinman, A., and Lin, Tsung-yi, eds., Normal and Abnormal Behavior in Chinese Culture, Dordrect: D. Reidel, 1981.
35. Michael, D.Ayur, M.A.H., Medicine Buddha Healing - Notes from a 6 Year Apprenticeship with Ayurvedic Physician Dr. Vasant Lad, B.A.M.S., M.A.Sc., 1st Draft Edition and personal interviews with the author, Berkeley, California: Medicine Buddha Healing Center, Ayurveda Healing Arts Institute: 2004.
36.
Krishnamurti, J., The
Collected Works of J. Krishnamurti,
37.
Lad,
Vasant, B.A.M.S., M.A.Sc., Ayurveda - The Science of Self Healing, 2nd ed.,
38. Lad, V., Dr., "Ayurvedic Psychology," Ayurveda Today, IV (1),
39.
Lad,
V., Dr., and Lad, U., "Food Guidelines for Basic Constitutional
Types," Ayurvedic Cooking for
Self-Healing,
40.
Lad
V., B.A.M.S., M.A.Sc., Secrets of the
Pulse - The Ancient Art of Ayurvedic Pulse Diagnosis,
41.
Lad,
V. B.A.M.S., M.A.Sc., Textbook of
Ayurveda – Fundamental Principles,
42.
Lad
V., B.A.M.S., M.A.Sc.; and Frawley, D., O.M.D., The Yoga of Herbs,
43. Larre, Claude, S.J., Rochat de la Vallée, Rooted in Spirit – The Heart of Chinese Medicine, New York, New York: Station Hill Press, 1995.
44. Liu, Yi-ren, translated by Yang, Shou-zhong, Dr. Liu Yi-Ren, Yi Xue Chuan Xin Lu (The Heart Transmission of Medicine), 1st ed., Boulder, Coloradolorado: Blue Poppy Press, 1997.
45. Maciocia, G.,
The Practice of Chinese Medicine – The
Treatment of Diseases with Acupuncture and Chinese Herbs,
46. Maciocia, Giovanni, Tongue Diagnosis in Chinese Medicine, revised ed.,
48.
Marieb,
E.N., R.N., Ph.D., Essentials of Human
Anatomy & Physiology, 4th ed.
50.
Melloni,
B.J., Ph.D.; and Eisner, G.M., M.D., The
HarperCollins Illustrated Medical Dictionary,
51. Mong, He, English-Chinese
and Chinese-English Course-based Medical Dictionary (Ying-Han - Han-Ying Zhong Yi
52.
Paradiso,
C., R.N., CCRN., Lippincott's Review
Series - Pathophysiology,
53.
Pitchford,
P., Healing with Whole Foods - Oriental
Traditions and Modern Nutrition,
55. Reid D. A Handbook of
Chinese Healing Herbs,
58.
Sachs,
R., Health for Life - Secrets of Tibetan
Ayurveda,
59.
Sharma,
P.V., editor - translator, Charaka-Samhita
– Agnivesa’s Treatise refined and annotated by Caraka and redacted by Drdhabala
(Sanskrit Text with English Translation), 2nd ed., Vol. I,
61. Sionneau, Philippe, B.S.TCM., Dui
62. Sionneau, Philippe, B.S.TCM. and Gang, Lu, M.S.TCM., The Treatment of Disease in TCM – Volume 1:
Diseases of the Head and Face Including Mental / Emotional Disorders,
64.
Svoboda,
R., Dr., Lade, A., LAc., Tao and Dharma -
Chinese Medicine and Ayurveda,
65. Tierra, M, L.Ac., N.D., O.M.D., Planetary Herbology - An Integration of Western Herbs Into the Traditional Chinese and Ayurvedic Systems, Twin Lakes, WI: Lotus Press, 1988.
66. Ti
71. Wu, Dr., A Manual of
Practical Internal Chinese Medicine (Shi Yong Zhong Yi Nei Ke Biao Dian),
75.
Zong,
Xiao-Fan, and Liscum, G., Chinese Medical
Palmistry - Your Health in Your Hand,
|
|
||||||
|
Side effects of commonly prescribed antidepressants |
||||||
|
Medication (common |
Dry mouth, constipation, blurred vision |
Sedation |
Postural changes in blood pressure |
Sexual dysfunction |
Gastrointestinal disturbances |
Insomnia |
|
Amitriptyline (Elavil) |
High |
High |
High |
High |
Low |
None |
|
Clomipramine (Anafranil) |
High |
High |
High |
High |
Low |
None |
|
Desipramine (Norpramin) |
Some |
Some |
Some |
High |
Low |
Some |
|
Doxepin (Sinequan) |
High |
High |
High |
High |
Low |
None |
|
Imipramine (Tofranil) |
High |
High |
High |
High |
Low |
None |
|
Nortriptyline (Pamelor) |
Some |
Some |
Some |
High |
Low |
None |
|
Citalopram (Celexa) |
None |
Low |
None |
High |
High |
Low |
|
Fluoxetine (Prozac) |
None |
None |
None |
High |
High |
High |
|
Fluvoxamine (Luvox) |
None |
Some |
None |
High |
High |
Low |
|
Paroxetine (Paxil) |
Low |
Low |
None |
High |
High |
Low |
|
Sertraline (Zoloft) |
None |
Low |
None |
High |
High |
Some |
|
MAOIs (isocarboxazid/Marplan; phenelzine/ Nardil; tranylcypro-mine/Parnate |
Some |
Some |
High |
High |
Low |
Low except Parnate (high) |
|
Bupropion (Wellbutrin) |
None |
None |
None |
None |
Some |
high |
|
Mirtazapine (Remeron) |
None |
None |
None |
None |
Low |
None |
|
Nefazodone (Serzone) |
None |
High |
Low |
None |
Some |
Low |
|
Trazadone (Desyrel) |
Low |
High |
High |
None |
Some |
None |
|
Venlafaxine (Effexor) |
None |
Low |
Low |
High |
High |
some |
|
Side effects of commonly prescribed mood-stabilizers |
|
|
Medication (brand name) |
Common side effects |
|
Lithium carbonate (Eskalith) |
Nausea, increased urination, thirst, hand tremor, GI distress (slurred speech, confusion when toxic) |
|
Carbamazepine (Tegretol) |
Dizziness, sedation, nausea, dry mouth, constipation, headache |
|
Valproic acid (Depakote) |
Sedation, hand tremor, nausea, diarrhea, abdominal cramps, hair loss |
|
Gaba-Pentin (Neurontin) |
Sedation, weight gain, ataxia, headaches, nausea |
|
Lamotragine (lamictal) |
Life-threatening skin rashes (rare) usually in first weeks of treatment, benign rash much more likely |
|
Side effects of commonly prescribed sedative-hypnotics |
|
|
Medication (common brand name) |
Side effects |
|
Flurazepam (Dalmane) |
Hangover effect, rebound insomnia after stopping |
|
Temazepam (Restoril) |
Anterograde amnesia, rebound insomnia after stopping |
|
Diphenhydramine (Benadryl) |
Dry mouth, constipation,, blurred vision |
|
Zolpidem (Ambien) |
Hangover effect (less often) |
|
Zaleplon (Sonata) |
Hangover effect (less often) |
|
Chloral hydrate |
Gastrointestinal irritation |
|
Side effects of commonly prescribed antipsychotics |
||||
|
Medication |
Acute or chronic neurologic side effects |
Dry mouth, constipation, blurred vision |
Sedation |
Postural changes in blood pressure |
|
Chlorpromazine (Thorazine) |
Some |
Some |
High |
High |
|
Thioridazine (Mellaril) |
Low |
High |
High |
High |
|
Perphenazine (Trilafon) |
High |
Low |
Low |
Low |
|
Haloperidol (Haldol) |
High |
Low |
Low |
Low |
|
Thiothixene (Navane) |
High |
Low |
Low |
Low |
|
Clozapine (Clozaril) |
Low |
High |
High |
High |
|
Quetiapine (Seroquel) |
Low |
Low |
Some |
Some |
|
Olanzapine (Zyprexa) |
Low |
Low |
Some |
low |
|
Risperidone (Risperdal) |
Low |
Low |
Low |
some |
[1] To
better explain Vata,
Pitta, and Kapha, the three constitutions (or humors) of Ayurveda,
which I will mention throughout this paper I need to introduce a bit of basic
theory: Similar to Traditional Chinese Medicine (TCM), Ayurvedic medicine, the
ancient, traditional medical system of India which arrives in the world around
2000 to 1500 B.C., is based on an energetic model (hot or cold) where the
natural constitution of the patient, diseases, thoughts, feelings, herbs,
foods, remedies, and treatments are all classified as hot-cold, moist-dry,
light-heavy, rough-smooth, weak-strong, etc. The entire Ayurveda system is
based on what is called Tri-dosha or the Three Humors (three
constitutions). In Ayurveda, a 'dosha' means 'fault', a
quality or substance that is controlled or neutralized by the balance of each
other. Tridosha could be considered the
unique and core principle of Ayurveda and is compared in importance to Qi (Vata) – Yang (Pitta) and Yin (Kapha) in
TCM. It is interesting that as Ayurveda has a double
system called "Shiva (Male) – Shakti (Female)" as part of its
philosophy it is not strongly focused on as the Three Humors. In TCM, there is
also a Three Humor diagnostic group (probably coming from
[2] “Not
knowing is true knowledge. Presuming to know is a disease. First realize that you are sick; then you can
move toward health. The Master is her
own physician. She has healed herself of
all knowing. Thus she is truly
whole.” I have found that the problem in
manic disorder is that patient is often a “know-it-all” who is “always right”
and doesn’t like to accept criticism.
This is a typical Pitta constitution or “Fire” person. Lao Zi, author; Mitchell, S., translator, Tao Te Ching – A New English Version,
[3] There is a mysterious Buddhist mantra reference to wind being related to anger in the Venerable Master Hsuan Hua’s Shurangama Mantra Verses and Commentary. In the Shurangama Mantra, an ancient Sanskrit Siddham mantra, the longest mantra in Buddhism, there is a line of the mantra that is “Wu mwo be di” in Sanskrit (Line #32 of 554). The poetry verse by Master Hua that explains as follows: “Most victorious, violent, and rapid, great wind spirit – Toppling houses, uprooting trees, he is quite fearsome. Even the third dhyana dreads this disaster. With feelings of anger and hatred one does oneself in.” Master Hua says, “ ‘Wu mwo be di’ is Sanskrit and means ‘extremely overpowering, violent, and rapid.’ This is the name of the wind spirit. This spirit has a monstrous temper. He is always quarreling and fighting. He is violent and speedy. There are gentle winds and seasonal winds that do not harm people. There is also the warm wind. ‘Wu mwo be di’, the wind spirit, has incredible power. He’s just plain fierce. He can blow buildings apart, rip trees up by the roots, and bounce cars down the highway like balls. Most victorious, violent, and rapid, great wind spirit… You don’t want to rub the wind spirit the wrong way. Do that and he’s sure to get angry. Anyone who gets angry has this wind spirit behind him or her, pumping one up. Where to disasters come from? The last line of the mantra verse makes this clear. With feelings of anger and hatred one does oneself in. If when one is a person, one has a lot of anger, then even though one has cultivated significant blessings and is reborn in the heavens, one must still undergo the retribution of the disaster of wind. Because the root of anger, resentment, and temper has not been cut off, one has to take this loss. This is the retribution for anger.” (Ven-Hua 81: 3-6) “The wind spirit is a manifestation of the Buddha Accomplishment” (Amoghasiddhi Buddha – Jeweled Accomplishment Buddha – the Buddha of the north – as in the north wind). This Buddha and his manifestation, the wind spirit ‘Wu mwo be di’, are all part of the Karma Division of the Buddha of the North (“Na mwo chye she jyu la ye” line 54 of the Shurangama Mantra), who “in the Northern Division along with Earth Store Bodhisattva leads a great number of ghosts and spirits in his retinue. Karmic retribution, for good or evil, is never off by a hair… If you do good, your retribution will be good; if you do evil, your retribution will be evil. If is never off by a hair. Plant a good cause, you reap a good fruit; plant an evil cause and reap an evil fruit.” (Ven-Hua 81: 19, 47-48) So, it seems, if I can humbly interpret, that Master Hua is saying that some diseases like manic-episodes (giant fast windy anger) of bipolar are karmic retribution for past causes planted. So this spirit ‘Wu mwo be di’, the wind spirit, who is really a transformation body of the Buddha of the North is working to teach you a lesson by suffering with the disease. This is why in Buddhism, Hindu and in Indian Ayurveda, Yoga and Tibetan Medicine, mantras and meditation are key to treatment of mental diseases. Chanting daily the Shurangama mantra, especially these lines “Wu mwo be di” (line #32) and “Na mwo chye she jyu la ye” (line #54) are very important for healing the mind.
[4] Wintermin® is called chlorpromazine or Thorazine [also known as Aminazin, Chlorpromazine, Largactil, Thorazine). See: “Thorazine Used As Punishment - Practitioner Suffers Cognitive Dysfunction After Injections” (ClearHarmony 04)
[5] The six Zang are heart, pericardium, spleen, lungs, kidney and liver. There are matching diagnosis symptoms for each of them; some of them are clear from a Western Medicine point-of-view like palpitations and blood vessels are suggesting heart, urinary problems are suggesting of kidney-bladder imbalance and cough, nasal problems are suggestive of lung imbalance. Other symptoms are not so clear from a Western point-of-view like relationship of ears or head hair to kidneys, insane or mental ill behavior and tip of tongue to heart, feelings of spaced-out, ungrounded to spleen. There are even relationships of physical postures and movement that used to direct TCM doctor to troubled organ system like problems with stretching or walking being heart related, problems associated with sitting being related to spleen, problems with standing being associated to kidneys etc.
[1] Based on
research question idea of Tran, Son, “Traditional Chinese Medicine with Stroke
Patients”,
[2] Source:
Found in the Sushruta Sutra 4:6.
Sushruta, a well known Ayurvedic physician – the Indian equivalent of
Huang Di (Yellow Emperor) – was a famous surgeon who taught and practiced
surgery in
[3] The
Buddha described the “remedy for achieving optimum health – “The Noble
Eightfold Path: 1. Right outlook. 2.
Right will. 3. Right speech. 4. Right action. 5. Right self discipline. 6. Right activity. 7. Right self knowledge. 8. Right self transcendence.” - These, when used correctly, can actually
cure mania. Singh R., Ph.D. Science and Philosophy of Indian Medicine,
[4] Based on
Tran, Son, “Traditional Chinese Medicine with Stroke Patients”,
[5] Based on
Tran, Son, “Traditional Chinese Medicine with Stroke Patients”,
[6]
Rosenzweig, M.R., Leiman, A.L., and Breedlove, S.M., Profs. UC Berkeley, Biological Psychology,
[7] The
Diagnostic and Statistical Manual of Mental Disorders, 4th edition
(1994). Zimbardo, P.G.; and Gerrig, R.J., Psychology and
Life, 14th ed.,
[8] Coon,
D., Introduction to Psychology -
Exploration and Application, 7th ed.,
[9] Hammer,
L., MD, Dragon Rises - Red Bird Flies - Psychology and
Chinese Medicine,
[10]
Paradiso, C., R.N., CCRN., Lippincott's Review Series - Pathophysiology,
[11]
Zimbardo, P.G.; and Gerrig, R.J., Psychology and
Life, 14th ed.,
[12]
Ehrlich, A., Medical Terminology for
Health Professionals, 3rd ed.,
[13]
Ehrlich, A., Medical Terminology for
Health Professionals, 3rd ed.,
[14]
Zimbardo, P.G.; and Gerrig, R.J., Psychology and
Life, 14th ed.,
[15]
Zimbardo, P.G.; and Gerrig, R.J., Psychology and
Life, 14th ed.,
[16] Holden, C., "Depression research advances, treatment lags," Science, 233, 1986: pp. 723-725.
[17]
Kessler, R.C., et al., "Lifetime and 12-month prevalence of DSM-III-R
psychiatric disorders in the
[18]
Zimbardo, P.G.; and Gerrig, R.J., Psychology and
Life, 14th ed.,
[19]
Ehrlich, A., Medical Terminology for
Health Professionals, 3rd ed.,
[20]
Zimbardo, P.G.; and Gerrig, R.J., Psychology and
Life, 14th ed.,
[21] Cheng,
Xinnong, ed., Chinese Acupuncture and
Moxibustion,
[22] Cheng,
Xinnong, ed., Chinese Acupuncture and
Moxibustion,
[23] Downer, J., "Using her history of manic-depressive illness to understand and help other victims," Time, Special Issue - "Heroes of Medicine," Fall 1997: p. 85.
[24] Calamus root – also called Vacha in Ayurvedic Sanskrit.
[25] Ding De-zheng, “Knowledge Based on Experience of the Acupuncture Treatment of Psychiatric Disorders,” Zhong Yi Za Zhi (Journal of Chinese Medicine), #2, 2001, pp. 86-87
[26] Ayurveda says to balance anger and mania with the sweet, cool, and dry scents below. These may be placed on the acupressure/acupuncture points above and/or on the chakra and/or on the soles of feet and scalp. Wear or vaporize essential oils such as:. Carnation (VPK - meditative), Jasmine (VP - sweet, cooling, moisturizing, nourishes tissues, strengthens nervous system, regulates menstruation, aphrodisiac, antibacterial, antidepressant, tridoshic but long-term use disturbs kapha), Jatamamsi (V-P-K- – Especially calming for vata, strongly scented root oil soothes, cools, clears, and grounds nervous system, promotes courage, strength and power while pacifying mind, promoting sound restful sleep, nutritive tonic with sedative properties, expectorant and demulcent, facilitates focus and awareness during yoga and meditation, due to cooling nature will elevate vata and kapha in long-term), Rose (V-P-K- – opens heart, love, compassion, queen of all fragrances, purifies negative emotions, encourages spiritual attunement), Peppermint (V=P-K+ – antiseptic, insect repellent), Kadam (V-P-K+), Kewara (V-P-K+), Lavender (V-P-K+ – soothes pitta and mind-body complex, antiseptic), Lotus (V=P-K+ – stimulates bhakti devotion), Mitti (VP - sandalwood with clay, properties similar to vetivert, grounding for vata, sweet and cooling for pitta, excessive use elevates kapha), Musta (V=P-K- – Pain killer, muscle relaxant, tranquilizer, mild analgesic, good for fibromyalgia, mood elevator), Nag Champa (V-P-K- – slightly sweet warming blend of magnolia, plumeria and other tropical flowers is light and elevating, pacifies deep feelings of heaviness, dispels kapha lethargy and vata-pitta moodiness while promoting joy and happiness, cultivates love and devotion), Nutmeg (V-P=K- – Analgesic, tranquilizer, best for vata occipital and forehead headaches, and used for vata and pitta acupressure), Saffron (V-P-K-), Sandalwood (V-P-K+ – best for meditation and concentration, sweet, cooling, dispels both pitta anger and vata anxiety, antibacterial, diuretic, nervine, sedative, antispasmodic, tissue regenerative, promotes ojas immunity compassion patience), Patchouli (V-P-K+ – grounding, calming, root and second chakras, stimulates psychic abilities, stops vata anxiety, pitta irritation, agitation, cooling and soothing), Vetivert - Khus (V=P-K+ – very cooling calming oil from stems of khus grass, purifies blood and mind and skin, calms solar plexus, improves concentration, dispels pitta anger and confusion, clarifies sense of purpose, woman’s hormone balancer, eases menopausal irritation and post-partum depression, grounding, strengthening, regenerating, antiseptic, promotes love, virility, aphrodisiac)
[27] Ding De-zheng, “Knowledge Based on Experience of the Acupuncture Treatment of Psychiatric Disorders,” Zhong Yi Za Zhi (Journal of Chinese Medicine), #2, 2001, pp. 86-87
[28] Cheng,
Xinnong, ed., Chinese Acupuncture and
Moxibustion,
[29] Cheng,
Xinnong, ed., Chinese Acupuncture and
Moxibustion,
[30] “Fan”
(2nd tone) is “described by Chinese clinicians in terms of
restlessness and ‘hot-headedness’ as a subjective feeling.” Ellis A.; et al. Fundamentals of Chinese Acupuncture,
Revised ed.
[31] Cheng,
Xinnong, ed., Chinese Acupuncture and
Moxibustion,
[32] Cheng,
Xinnong, ed., Chinese Acupuncture and
Moxibustion,
[33] Cheng,
Xinnong, ed., Chinese Acupuncture and
Moxibustion,
[34] Cheng,
Xinnong, ed., Chinese Acupuncture and
Moxibustion,
[35] Cheng,
Xinnong, ed., Chinese Acupuncture and
Moxibustion,
[36] Cheng,
Xinnong, ed., Chinese Acupuncture and
Moxibustion,
[37] Cheng,
Xinnong, ed., Chinese Acupuncture and
Moxibustion,
[38] Cheng,
Xinnong, ed., Chinese Acupuncture and
Moxibustion,
[39] Stone, A., "Acupuncture Treatments for Schizophrenia," 1997, Internet Source: http://www.acupuncture.com/Clinical/Schizo.htm
[40] Stone, A., "Acupuncture Treatments for Schizophrenia," 1997, Internet Source: http://www.acupuncture.com/Clinical/Schizo.htm
[41] Bhishagratna, K.L., trans., An English Translation of the Sushruta Samhita - Based on the original Sanskrit text - in three volumes, vol. III, Varanasi, India: Chowkhamba Sanskrit Series Office, 1991: p. 388.
[42] Jolly,
J., and Barg, M., The Secret of Life
Study Guide, 2nd ed.,
[43] Reid D.
The Complete Book of Chinese Health and Healing,
1st ed.
[44]
Postlethwait, J.H.; and Hopson, J.L. The
Nature of Life, 3rd ed.
[45]
Zimbardo, P.G.; and Gerrig, R.J., Psychology and
Life, 14th ed.,
[46] Joesten, M.; Netterville, J.; and Wood, J. The World of Chemistry Essentials
[47] Mann,
F., MB, Acupuncture: The Ancient Chinese
Art of Healing and How It Works Scientifically, 3rd ed.,
[48] Chen, Jirui, MD, and Wang, N. M.Sc., ed., Acupuncture Case Histories from China, Seattle, WA: Eastland Press, 1996: pp. 281-283.
[49] Reid D.
The Complete Book of Chinese Health and Healing,
1st ed.