1
Depression is characterized by depressed mood, restlessness, chest fullness, rib pain, easy irritability or crying, and a feeling of throat obstruction. If depression continues, it can lead to pessimism, suicidal thoughts, or behaviors. (Refer to the story at the end for a better understanding).
Ancient medical practitioners conducted extensive research on depression and its treatment. For example, in treating throat obstruction, the famous physician Zhang Zhongjing of the Han Dynasty used the Banxia Houpo Tang (which includes pinellia tuber, magnolia bark, poria cocos, among others).
One of the Four Great Masters of the Jin and Yuan Dynasties, Zhu Danxi, conducted in-depth research on depression. He believed that when the qi and blood are harmonious, diseases are less likely to occur; however, if there is depression, various illnesses will arise. Therefore, many diseases in the body are often related to depression.
Viewing depression as the source of various diseases highlights the importance ancient physicians placed on emotions.
Zhu Danxi categorized depression into six types: qi depression, blood depression, damp depression, phlegm depression, fire depression, and food depression.
2
Let’s first look at qi depression. The concept of qi depression has been mentioned as early as the Huangdi Neijing, often caused by emotional discomfort leading to stagnation of qi. In other words, psychological depression is the most common trigger for depression.
Ancient medical texts provide various theories and prescriptions for treating qi depression. For example, Zhu Danxi pointed out that the symptoms of qi depression include chest and rib pain, and a slow and rough pulse. Treatments for qi depression involve resolving stagnation. Prescriptions such as Qiyu Tang, Muxiang Diaoqisan, and Qiqisan are used. If qi depression transforms into phlegm, medications like Wendaan Tang, Banxia Houpo Tang, and Shangxia Fenxiaodaotang are used. If qi depression transforms into heat, prescriptions like Jiawei Xiaoyao San are utilized.
The vitality of a person lies in their qi, so the other five types of depression—blood depression, damp depression, phlegm depression, fire depression, and food depression—all stem from qi depression and influence each other.
Blood depression is caused by sudden anger, excessive labor, irregular eating habits, and others.
Those with blood depression often experience stabbing pains in the chest and ribs, frequent urination, and reddish stools. Treatment involves harmonizing the blood and resolving depression using Ajiao Sangmagao, Xieyutang, Siwu Huaye Tang, among others.
Damp depression results from external dampness that accumulates on the skin and muscles, causing sharp pains in the limbs and joints, particularly worsening during humid weather. Treatment aims at removing dampness and relieving depression using Shuyutang and Shengyang Chushitang.
Phlegm depression arises due to the combination of qi and fire. If the qi is stagnant, water cannot circulate, and if fire stagnates, the moisture transforms into phlegm. Phlegm can be categorized into visible and invisible types. Visible phlegm is expelled through coughing and wheezing and is mainly associated with spleen dampness rather than liver Qi or liver fire. Hence, it is not discussed here.
In contrast, the phlegm discussed here is primarily invisible and manifests as follows:
1. Irritability, insomnia, headaches, and disturbing dreams.
2. Chest tightness, vomiting, and intermittent restlessness.
3. Confusion, madness, and not recognizing people.
4. Clear-edged blocks that are not painful to the touch.
5. Discomfort in the limbs, sudden vision, and hearing problems.
Treatment for these symptoms mainly focuses on eliminating phlegm and alleviating depression. Common prescriptions include Meishiguntan Pill (made from magpie stone, agarwood, skullcap root, rhubarb, etc.), primarily targeting madness, severe headache, insomnia, constipation, or dry and hard stools.
Fire depression refers to latent heat residing within the body, such as in warm disease theory where heat approaches the vital Qi, leading to symptoms like body heat without aversion to cold, restlessness and thirst, a yellow tongue coating, with the defensive Qi being closed off without sweating. This condition requires pungent-cool dispersing medicines to induce slight sweating, allowing the heat to dissipate; for instance, if there is heart fire flaring, oral ulcers, and heat shifted from the heart to the small intestine resulting in dark red urine and painful urination, then the prescription is to clear the heart and small intestine’s fire with Daore San (a proprietary Chinese medicine consisting of raw rehmannia, akebia stem, licorice twig, and bamboo leaf).
Food depression occurs due to indigestion leading to stagnation of Qi. Symptoms include acid reflux, bloating, inability to eat, jaundice, distension, mass in the abdomen, and a tight pulse. Treatment focuses on promoting digestion and resolving depression using Shiyutang, Erchenting combined with Baohe Pills, among others.
Although each type of depression has specific treatment methods, Zhu Danxi presented two widely applicable formulas after his discourse:
These are the Liu Yu Tang and Yue Ju Wan.
The Liu Yu Tang formula is recorded in Volume 2 of “Medical Classics.”
Composition: Dried tangerine peel (peeled) 3g, pinellia (processed with ginger juice seven times) Atractylodes rhizome (soaked rice wash) Cyperus (processed) each 3g, red poria, gardenia (fried) each 2.1g, Cyperus wood 6g, licorice (stir-fried) 1.5g, sand ginger (crushed) 1.5g.
For usage, add three slices of fresh ginger, boil with 300ml of water until reduced to 150ml, and serve warm.
This formula is the basic prescription for all types of depression.
For qi depression, add sparganium, cyperus, and areca.
For damp depression, add white atractylodes and double the Atractylodes.
For fire depression, add coptis and double the gardenia.
For phlegm depression, add pinellia, orange peel, and zanthoxylum shell.
For blood depression, add peach kernel, safflower, and moutan bark.
For food depression, add hawthorn, medicated leaven, and waxy barley.
The Yue Ju Wan (also known as Chuan Xanthium Pill) is recorded in Volume 3 of “Danxi Mind Book.”
Composition: Atractylodes, Cyperus, Cyperus, medicated leaven, gardenia, each equivalent.
Grind the above ingredients into a powder, form into pills using water, each the size of a green bean. Take 6-9g per dose, swallow with warm water. Can also be used as a decoction, boiled and consumed. Note: This is a proprietary Chinese medicine.
This formula promotes Qi circulation and relieves depression, effective for all types of depression.
In this formula: Atractylodes promotes Qi circulation and relieves depression, treating qi depression. Chuan Xanthium activates blood circulation and Qi flow, treating blood depression. Atractylodes dampness and strengthens the spleen, addressing damp depression. Gardenia clears heat and relieves irritability, treating fire depression. Medicated leaven aids digestion and harmonizes the middle burner, addressing food depression.
Why does this formula not contain remedies for phlegm depression? This is because phlegm depression is associated with qi, fire, and food depressions. Therefore, no separate medication for phlegm depression is included in the formula, following the principle of treating the root cause of the illness.
3
The above detailed the traditional Chinese medicine treatments for depression by ancient renowned physicians. As mentioned earlier, regardless of the type of depression, it usually starts with qi depression, related to emotional discomfort. In the history of medicine, there is a famous and humorous case where the well-known physician Zhen Quan, who lived through the Southern and Northern Dynasties, Sui Dynasty, and Tang Dynasty, spanning three dynasties, cured the imperial physician Li Zonglin of the Tang Dynasty.
Li Zonglin fell ill due to dissatisfaction with Emperor Taizong’s visit to comfort Zhen Quan, harboring resentment. Despite various imperial physicians prescribing treatments, none were successful. Surprisingly, when Zhen Quan arrived, he diagnosed: “From the pulse, it seems Mr. Li is experiencing some menstrual irregularity and has a blockage in the abdomen. Let me prescribe a remedy to regulate his condition.”
This statement even led Emperor Taizong to misunderstand, as how could a man experience menstrual irregularity? Zhen Quan appeared to be talking nonsense. Li Zonglin was unimpressed by the renowned physician Zhen Quan. However, after several bouts of laughter, he vomited out the blood clot causing his chest depression, and he was completely cured.
In ancient times, prescription medication focused on herbal formulas, and laughter could indeed be the best medicine for depression, as it is both easy to find and difficult to find compared to other remedies.
