Chinese medicine believes that there are sun, moon and stars in the sky, and people have essence, qi and spirit. "Those who get the spirit prosper, and those who go against the spirit die." God is the general name of human life activities, and it is also a high generalization of spiritual consciousness, thinking activities and external manifestations of functional activities of viscera, essence, blood and body fluid. In other words, the circulation law of human qi, blood, body fluid and thinking activities comes from its own regulation. The etiology and pathogenesis of mental illness have always been different from doctors' opinions, but in general, it seems that there are nothing more than the following.
1. Six evils invade six evils, that is, wind, cold, heat, dampness, dryness and fire, which are natural phenomena of natural climate and generally do not cause diseases, and are called six evils. Only in the case of abnormal climate will people die, which is also commonly known as six evils. Among the six evils, there are three kinds related to mental illness: wind, summer and fire. Su Wen has the saying that "the wind hurts the world first" and "all madness belongs to fire" But whether it is "wind, summer heat" or "dry fire", it is always when the human body is weak that it can take advantage of it and make people sick. However, "excess heat" is still regarded as an important aspect of etiology and pathogenesis.
2. The seven emotions of happiness, anger, worry, thinking, sadness, fear and shock are normal manifestations of people's psychological activities, but if they exceed the normal limit or are stimulated suddenly and for a long time, they will lead to physiological and visceral dysfunction, meridian dysfunction and mental illness. In addition, there are phlegm, stagnation of qi and blood, disharmony between yin and yang, heredity, consanguineous marriage, brain trauma, brain organic diseases, poisoning and so on. In order to deepen the knowledge and understanding of mental illness, it is necessary to understand its etiology and pathogenesis, so as to effectively apply the theory of syndrome differentiation of brain clearing in traditional Chinese medicine, alleviate the pain of mental patients and make them recover as soon as possible. There are three keys to TCM treatment: First, dredge qi. When qi is running, the blood flows smoothly, the viscera function is normal, and the disease and syndrome are relieved. The second is the close cooperation and application of the method of suppressing yang and calming the nerves. Pathogenic turbidity in kangqingqiao can be reduced, while quiet qi can be raised, and the intercourse between Yin and Yang Can is as usual. Third, attach importance to the handling of the relationship between collaterals, neighbors and transmission of viscera and meridians. For example, dysfunction of spleen and stomach can lead to excessive phlegm, insufficient heart blood, and qi-blood imbalance. Spleen and stomach are connected by meridians, forming an exterior-interior relationship. The nutrients (qi, blood, body fluid) needed by the human body nourish the whole body through the absorption of Shui Gu by the stomach and the transport function of the spleen, relying on the digestion and absorption of food and the distribution of qi, blood and body fluid. Therefore, the spleen and stomach are also called "the foundation of the day after tomorrow". When the spleen loses health and the stomach loses harmony, qi and blood will be passive, body fluids will not be normalized, and pathological products such as dampness, phlegm and drinking will be formed, and the "spleen and stomach deficiency and cold syndrome" will be born. Treating "madness and depression" based on syndrome differentiation with "deficiency of spleen and stomach" is the fundamental difference between the treatment of mental disorders in our hospital and the treatment based on "calming the heart and calming the nerves" by other doctors. The specific rules are as follows:
Pungency and bitterness: Pungency and bitterness are used to regulate the pathological changes of qi in the disease. Pungent drugs have the function of dispersing qi and promoting qi, while bitter drugs have the function of stopping diarrhea and relaxing bowels. Pungent medicine is pungent, sweet and warm, while heavy medicine is bitter, sour, astringent and cold. The pungent taste belongs to yang, and the bitter taste belongs to yin. The combination of hard medicine and taste * * * completes the whole process of promoting qi circulation, promoting hair growth, excreting and reducing turbidity, * * * adjusts the balance of yin and yang of the body and ensures the benign circulation of gas in the human body. There are two kinds of clinical ingredients in herbal medicine. One is that some herbs have two kinds of bitter taste, which is beneficial to qi; Secondly, it is a prescription for regulating the circulation of qi composed of bitter and bitter drugs. This method is widely applicable to mental disorders of various types of experience.
Soothing the liver and regulating qi: Soothing the liver and regulating qi is a horizontal method of regulating qi. The selected drugs are mostly composed of drugs of liver, gallbladder, spleen and stomach meridians. Mainly used for qi stagnation syndrome of viscera such as liver, gallbladder, spleen and stomach. Clinical indications are chest and hypochondrium, breast, paunch, testicular swelling and pain, dysmenorrhea, menstrual disorder and so on. It is also suitable for headache at the top and both sides. The combination of soothing the liver and regulating qi with calming the heart and relieving pain can harmonize qi movement and treat it in all directions.
Pacing the liver and suppressing yang: Pacing the liver and suppressing yang is a method to restore the hyperactive yang to its original position through herbs, so that it floats on the wind and fire, and purges, thus regulating brain dysfunction. It includes herbs for calming the heart and calming the nerves, nourishing yin and suppressing yang, and is mainly suitable for deficiency of kidney yin and hyperactivity of kidney yang. Water does not contain wood, and liver yang is hyperactive; Kidney water loss, fire burning alone; The liver meridian, wind and fire directly reach the brain; The brain itself is a disordered yang. The main clinical manifestations are dizziness, headache, insomnia, panic and anger, facial muscle tremor, limb tremor, convulsion, abnormal behavior or sudden fall to the ground.
Strengthening the brain and calming the nerves: methods such as strengthening the brain and calming the nerves are to treat the symptoms of uneasiness with herbs that soothe the nerves and some drugs that enrich blood and nourish blood. The main clinical manifestations are insomnia, delirium, dizziness, headache, tinnitus like cicada, dreaminess, forgetfulness, palpitation, convulsion and epilepsy. In traditional medicine, nourishing the heart and calming the nerves is actually mainly nourishing the brain and calming the nerves, followed by nourishing the heart and calming the nerves.
Regulating qi and promoting blood circulation: Treating qi stagnation and blood stasis syndrome caused by emotional diseases by regulating qi and promoting blood circulation. The compatibility of drugs for regulating qi and promoting blood circulation should be determined according to the amount of qi stagnation and blood stasis in clinic. The main clinical manifestations are pain in the head, chest, hypochondrium, abdomen or whole body, and it is also suitable for amenorrhea, dysmenorrhea and psychosis with ineffective conventional methods. Among them, the nature of pain is tingling, and the position is relatively fixed.
Regulating qi and inducing stagnation: the method of regulating qi and inducing stagnation is suitable for food retention syndrome caused by emotional changes. This method is based on the combination of some qi-regulating drugs and herbs that promote digestion. Mainly suitable for abdominal distension, acid swallowing, anorexia, indigestion of stool, muddy tongue coating and slippery pulse. Regulating qi and guiding stagnation can be supplemented by strengthening the spleen to help transport, so that digestion can be thoroughly guided.
Diuresis and detumescence: diuresis and detumescence is a syndrome of diuresis and detumescence herbs for treating qi stagnation and water stagnation. Clinically, some drugs for regulating qi should be used appropriately, and qi should go with water. The main manifestations are facial or systemic edema, less urine, fullness in chest and hypochondrium, loss of appetite and menstrual edema. In addition to promoting diuresis and reducing swelling, we should also add prescriptions for invigorating spleen and regulating stomach, promoting qi circulation and promoting diuresis, and invigorating spleen and promoting diuresis to completely eliminate edema.
Humidification: Humidification is suitable for gas stagnation and wet condensation. For depression, the formation of dampness can be divided into external dampness and internal dampness. The former is mostly caused by six evils, while the latter is mostly caused by emotional changes. The clinical manifestations of external dampness are: general lethargy, chest tightness and fullness, thin stool, white greasy tongue coating and wet pulse. Internal dampness syndrome is characterized by weakness of limbs, drowsiness, abdominal distension, chest pain, white and greasy tongue coating, and slow pulse. Damp-removing drugs are mostly pungent and warm products, which have the function of promoting qi circulation. Specific drugs should be given the methods of regulating qi and relieving exterior syndrome or aromatizing dampness, promoting qi and removing turbidity according to the causes of dampness.
Aromatic resuscitation method: Aromatic resuscitation method is a pungent herb, which is mainly used to refresh the brain and treat sudden fainting, epilepsy, stroke and other symptoms caused by qi stagnation or phlegm obstruction. The main manifestations are unconsciousness, fist-clenching, spitting, limb twitching, slippery pulse and unconsciousness, blue face and cold body, drowning in hands, delayed fur and white pulse. This herb should not be used for a long time, so as to avoid the fragrant and dry products consuming gas and damaging yin.
Eliminating phlegm and turbidity: the method of eliminating phlegm and turbidity is to treat phlegm and turbidity blocking collateral syndrome caused by emotional changes. The main clinical manifestations are sudden unconsciousness, unconsciousness, salivation in the mouth, mouth and eyes askew, phlegm in the pharynx, hemiplegia, numbness of limbs, thick and greasy tongue coating, and slippery pulse. Clinically, it can also be used to treat emotional diseases that are ineffective by conventional methods or traditional Chinese medicine for promoting blood circulation. Most diseases are caused by phlegm. Materia Medica for eliminating phlegm and turbidity is often composed of drugs for promoting qi circulation, promoting blood circulation and inducing resuscitation.
Clearing heat and purging fire: clearing heat and purging fire is a syndrome of treating qi stagnation and fire or exogenous fire evil caused by mental and emotional changes. The main manifestations are irritability, dizziness, red eyes, deafness and hypochondriac pain, bitter taste and soft muscles, turbid blood, red tongue with yellow coating and rapid pulse. Syndrome of exogenous pathogenic fire depends on what is dirty. Use heat-clearing and purging gunpowder, and add a small amount of qi-regulating drugs at the same time.
Supplementing qi and blood: For a long time, the method of supplementing qi and blood has been applied to the diseases of seven emotions, resulting in the loss of qi and blood in the body. Clinical deficiency syndrome is often mixed with empirical lesions, and drugs to eliminate evil factors are added on the basis of tonifying. The specific tonic method depends on the deviation of deficiency of both qi and blood. The clinical manifestations of patients with qi deficiency include shortness of breath, fatigue, fright, spontaneous sweating, lethargy, poor memory, pale tongue and weak pulse. Those with excessive blood deficiency have pale complexion, palpitation and insomnia, dizziness, forgetfulness, listlessness, pale tongue and thready pulse. If both qi and blood are deficient, the above symptoms can occur at the same time.
Adjusting yin and yang: the method of adjusting yin and yang is suitable for the syndrome of yin and yang being positive in emotional diseases. It is mainly used for insomnia, fever, anxiety, palpitation, emaciation, night sweats, red tongue with little body fluid, thready pulse, cold limbs, weakness of waist and knees, listlessness, pale tongue with thin coating, heavy and thin pulse, and delayed pulse. Yin deficiency syndrome is common in clinic, but Yang deficiency syndrome is rare. Both yin and yang are deficient, so they should be supplemented to make up for their disadvantages. The adjustment methods of yin deficiency and yang deficiency should also be adjusted according to the degree of viscera and deficiency.
Tonifying essence and marrow: Tonifying essence and marrow is a kind of herbal medicine that nourishes kidney essence to treat collapse. Especially flesh and blood filling is more beneficial. This syndrome is mainly manifested as dizziness, tinnitus, mental emptiness, backache and leg weakness, mental retardation, slow movement, toothache, nocturnal emission and premature ejaculation, fat tongue and weak pulse, especially in the foot. This syndrome takes too long, so the treatment should be slow.
One of the above treatment principles is that clinical treatment can be used together.
Herbs for treating manic depression, one is pungent and fragrant, the other is to stop the disease with positive evidence, and to use it with caution in deficiency syndrome.
Herbs that tonify qi and blood, regulate yin and yang, nourish essence and replenish marrow are mostly greasy, and the dosage should not be too large, and the number of flavors should not be too much.
The fourth is to add a small amount of qi-regulating drugs.
Toning the brain and calming the nerves, nourishing the heart and strengthening the spleen; The fifth is to save the disadvantages of emotional bias and yin damage, and attach importance to the treatment of yang damage to the heart and spleen.
Sixth, use diazepam to calm sleep, make up for the lack of curative effect of herbs, and aim to control the dilemma of insomnia, mental mania and upset in a short time.