In patients with Yang syndromes, there is a lack of communication both internally and externally; in patients with Yin syndromes, there is a deficiency of fluids, blood, and Qi.
Depressive disorders arise from the gradual transition from Yang to Yin, which is a change from obstruction to deficiency.
Thus, depressive disorders do not present with high fever; even in the presence of restlessness, it is merely a sign of heat deficiency. If there is a significant fever, then it indicates symptoms of restlessness and depression.
This is because the heat of the three Yangs is quite intense, especially the dryness of the Shao Yang, and the strong heat of the Yang Ming’s lungs and stomach is evident. Restlessness and depression stem from the dryness and heat of the Yang Ming stomach channel.
Depressive disorders generate heat due to deficiency, not excess; on the contrary, it is still about insufficiency.
This type of heat due to deficiency can be cleared; however, clearing heat is not a fundamental treatment strategy.
Heat must be continually cleared and requires supplementation of deficiencies to achieve balance. This can be referred to as Yin deficiency or blood deficiency; there is little difference between them—both Yin fluids and blood are affected together.
Depression and restlessness do not exclude each other.
Endocrine disorders can manifest as two contradictory emotions, but they do not occur simultaneously.
When there is obstruction, it is easy to be restless; as the Qi and blood change, with blood and Qi gradually declining, depression will occur.
Occasionally, when the Qi and blood improve but then encounter obstruction again, restlessness will arise, creating an unpredictable cycle.
The temperament is unstable, sometimes good and sometimes bad; both good and bad are predetermined.
A deep and thin pulse represents a sign of deficiency.
Can there be stasis in deficiency? Indeed, there can.
A deep, thin, and weak pulse is a clear sign of pure deficiency, and supplementation is undoubtedly required. A deep, thin, and slippery pulse indicates a sign of excess, necessitating both supplementation and unblocking.
The observation of the tongue coating is similar.
If the coating is thick and slippery, it is advisable to unblock it. A red, swollen tongue indicates excess and should be drained. A pale, thin tongue indicates deficiency and should be supplemented.
The methods of unblocking, supplementing, and draining ultimately relate back to the deficiency and excess of the liver.
The deficiency and excess of the liver are also reflected in the blood.
Therefore, in clinical practice, we often use Si Wu Decoction combined with Xiao Chai Hu Decoction, which generally yields good results.
Si Wu Decoction reinforces the blood of Jue Yin; Xiao Chai Hu Decoction harmonizes Shao Yang. The combination of the two aptly addresses the transition of depressive disorders from Yang to Yin.
