Library

Dian (Manic-Depressive Psychosis) belongs to Yin, while Kuang (Mania) belongs to Yang. Dian is characterized by excessive joy (or preference for quietness), whereas Kuang is characterized by excessive anger (or agitation). A deficient pulse indicates a treatable condition, while an excess pulse suggests a fatal prognosis. Generally, these conditions are caused by phlegm knotting in the chest and heart region; treatment should focus on calming the Shen (Spirit) and resolving phlegm knots. Some cases arise from invasion by pathogenic factors, which should be treated according to methods for expelling pathogens; the discussion in *Yuan Bing Shi* (Treatise on the Original Causes of Diseases) is particularly refined. This corresponds to what the world calls "excess Yin leads to Dian, excess Yang leads to Kuang," which is generally due to heat. Dian involves the Shen failing to reside in its proper place, resulting in delirious speech as if seeing things, persisting for years without cure. If accompanied by tinnitus, use Tian Men Dong (Asparagi Radix), removing the heart, drying it, grinding it into powder, and taking one fangcun bi (a measure roughly equivalent to a tablespoon) with wine. For Dian syndrome, if treated in spring, it will naturally settle by summer; herbs that tonify Heart Qi are appropriate. Deficiency of Yang with Excess of Yin leads to Dian; Deficiency of Yin with Excess of Yang leads to Kuang. Kuang disease is best cured by inducing vomiting and purging.

The following formula treats Dian Feng (Wind-induced Mania):
Hemp Seed (Semen Cannabis, Mahu Ren) - 4 sheng
Take six sheng of water, boil vigorously until reduced to two sheng, strain the dregs, and further decoct to obtain seven he. Take in the morning on an empty stomach. Whether the patient attacks or not, or speaks excessively, do not be alarmed; simply have someone hold the patient's hands and feet to keep them calm. After three doses, the patient will recover.

Another formula: Treats Kuang Xie (Maniacal Deviation) occurring at any time, with disheveled hair, loud screaming, desire to kill, and disregard for fire and water.
Sophora Root (Radix Sophorae Flavescentis, Kushen) - as needed
Grind into powder, make pills the size of sophora seeds with honey. Take fifteen pills each time, washed down with mint decoction.

Jing Ji (Palpitations due to Fright) is caused by Blood deficiency. For palpitations that occur intermittently, use Zhu Sha An Shen Wan (Cinnabar Pill for Calming the Spirit). For Phlegm misting the Heart and Diaphragm, various phlegm-resolving herbs can be used; add Hu Po (Amber) and Yu Jin (Curcuma Longa Rhizome) to Ding Zhi Wan (Pill for Stabilizing the Spirit). Zheng Chong (Constant Palpitations/Anxiety) is also due to Blood deficiency. Constant palpitations are more common in those with low blood volume; they occur when thinking, belonging to deficiency syndromes. Intermittent palpitations are caused by Phlegm stirred by Fire. Thin individuals often suffer from this due to low Blood, while fat individuals are associated with Phlegm; ordinary palpitations are mostly due to Phlegm. True sensation of violent heartbeat is due to low Blood; use Si Wu Tang (Four Substances Decoction) or Zhu Sha An Shen Wan. If the cause is fright, fright causes the Shen to leave its residence; emptiness in the residence generates Phlegm.

Dai Yuanli stated: Zheng Chong refers to inner unease, feeling fearful and apprehensive as if someone were about to capture you.

[Appendix] The master of humans is the Heart, and what nourishes the Heart is Blood. Once Heart Blood becomes deficient, the Shen (Spirit) cannot remain secure; this is the origin of Jing Ji (Palpitations due to Fright). Are there distinctions between Jing (Fright) and Ji (Palpitations)? Jing refers to terror; Ji refers to Zheng Chong (constant palpitations). When the Heart is deficient and contains stagnant Phlegm, hearing loud noises, seeing strange objects, encountering danger, or facing crises causes the will to falter, disturbing the Heart and creating a state of apprehension; this is Jing. When the Heart is deficient and retains Water, fluid sounds are heard in the chest; moving deficient Qi allows Water to ascend, which the Heart Fire dislikes, causing the Heart to feel insecure and creating a state of dissatisfaction; this is Ji. For Jing, administer formulas that resolve Phlegm and calm fright; for Ji, administer formulas that drain Water and eliminate retained fluids.所谓的扶虚 (Supporting deficiency) merely involves nourishing Heart Blood and harmonizing Heart Qi.

The following formula treats severe deficiency and palpitations due to overwork:
Cinnabar (Zhu Sha)
Angelica Sinensis Root (Dang Gui Shen)
White Peony Root (Bai Shao)
Biota Tops (Ce Bai Ye) - stir-fried, 5 qian
Ligusticum Chuanxiong Rhizome (Chuan Xiong)
Tangerine Peel (Chen Pi)
Licorice Root (Gan Cao) - 2 qian each
Coptis Rhizome (Huang Lian) - stir-fried, 1.5 qian
Grind into powder, make pills using pig Heart Blood.

Attached Formulas:
Yang Xin Tang (Decoction for Nourishing the Heart): Treats Heart deficiency and low Blood, causing restless palpitations.
Astragalus Root (Huang Qi) - roasted
Poria (Bai Fu Ling)
Poria with Hostwood (Fu Shen)
Fermented Wheat Leaven (Ban Xia Qu)
Angelica Sinensis Root (Dang Gui)
Ligusticum Chuanxiong Rhizome (Chuan Xiong) - half liang each
Polygala Root (Yuan Zhi) - remove heart, stir-fried with ginger juice
Cinnamon Twig (La Gui)
Biota Seeds (Bai Zi Ren)
Ziziphus Seed (Suan Zao Ren) - stir-fried
Schisandra Fruit (Wu Wei Zi)
Codonopsis Root (Ren Shen) - 2.5 qian
Licorice Root (Gan Cao) - roasted, 4 qian
Take three qian per dose, decoct with water, add three slices of ginger and one jujube, take before meals. For Zheng Chong due to retained water, add Areca Seed (Bing Lang) and Red Poria (Chi Fu Ling).

Ning Zhi Wan (Pill for Calming the Mind): Treats Heart and Blood deficiency with frequent fright. If there is Phlegm-Fright, vomiting is appropriate.
Codonopsis Root (Ren Shen)
Poria (Bai Fu Ling)
Poria with Hostwood (Fu Shen)
Biota Seeds (Bai Zi Ren)
Amber (Hu Po)
Angelica Sinensis Root (Dang Gui)
Ziziphus Seed (Suan Zao) - soaked in warm wine for half a day, shell removed, stir-fried between papers
Polygala Root (Yuan Zhi) - half liang each, stir-fried
Frankincense (Ru Xiang)
Cinnabar (Zhu Sha)
Acorus Rhizome (Shi Chang Pu) - 2.5 qian
Grind into powder, make pills the size of sophora seeds with refined honey. Take thirty pills, swallowed with jujube decoction after meals.

Zhu Que Wan (Vermilion Bird Pill): Treats persistent Zheng Chong due to Heart disease.
Poria with Hostwood (Bai Fu Shen) - 2 liang
Agarwood (Chen Xiang) - 5 qian
Grind into powder, make pills the size of soybeans with refined honey. Take thirty pills, washed down with Codonopsis decoction.

Jia Wei Si Qi Tang (Modified Four Seven Decoction): Treats stagnation of Heart Qi, resolving Phlegm and dispersing fright.
Pinellia Tuber (Ban Xia) - 2.5 liang
Poria (Bai Fu Ling)
Magnolia Bark (Hou Po) - 1.5 liang each
Poria with Hostwood (Fu Shen)
Perilla Leaf (Zi Su) - 1 liang each
Polygala Root (Yuan Zhi) - stir-fried
Licorice Root (Gan Cao) - roasted, half liang
Take four qian per dose, decoct with five slices of ginger, one inch of Acorus Rhizome, and one jujube in water.

Zhu Sha An Shen Wan (Cinnabar Pill for Calming the Spirit):
Cinnabar (Zhu Sha) - 5 qian, water-triturated, ground separately
Coptis Rhizome (Huang Lian) - 6 qian, washed with wine
Licorice Root (Gan Cao) - roasted, 2.5 qian
Rehmannia Root (Sheng Di Huang) - 1.5 qian
Angelica Sinensis Root (Dang Gui) - 2 qian
Grind the four ingredients into powder, make pills the size of millet grains using steamed bread paste, coat with Cinnabar. Take twenty or fifty pills, swallowed with saliva.

Ding Zhi Wan (Pill for Stabilizing the Spirit): See the section on Forgetfulness.