SYMPTOMS AND SIGNS: Depressive syndrome is a group of symptoms caused by the Qi stagnation due to the depressive emotion. Symptoms show depression and down, emotionally unstable, full and extended sensations at chest or hypochondriac regions; or restlessness, strong desire to cry; or obstruction feeling at throat which can not be swallowed or vomited, insomnia, etc. Neurasthenia, hysteria, and menopausal syndrome also belong to this group.
ETIOLOGY AND PATHOLOGY: The fundamental factor of depression is caused by the Qi stagnation due to prolonged lower and unstable emotions. The stagnated Qi gradually cause the disharmony of Qi-blood and Yin-Yang, as well as the disorders of some major organs, such as liver, spleen, and heart. Liver is an organ which needs to be in a harmonious, easy, and fully functioning state, so it can play the role as regulating and adjusting all emotions. The prolonged unstable emotions can cause the Qi stagnation which will obstruct the functions of liver; then, the excessive liver Qi is going to over-act on the spleen which normally controls the function of spleen according to the theory of five elements. After the liver Qi's attacking, spleen and stomach lose their functions of food digestion, transformation and transporting. Heart is the organ which controls the mind and spirit by its nourishing function. So the disorders of liver, spleen and heart are going to produce dampness, phlegm, or combined with heat or fire factors, which in reverse, are going to cause more disorders for other organs, or Qi and blood, or Yin and Yang.
1. Depressive Syndrome of Si (Excess) Type:
(1). Depressive Syndrome due to the Stagnated Liver Qi:
Indications: Depression, unstable emotions, frequent sighing, full, painful or extended sensation at chest and hypochondriacal regions, fullness at gastric region and abdomen, belching, no or poor appetite, or vomiting, irregular stool and menstruation, thin and greasy tongue coating, wiry pulse.
Treatment & Formula: Regulate Qi and harmonize liver.
- Xiao Yao San (Tang-kuei and Bupleurum Formula, Item No. 2105): This is the typical formula for the disharmony of liver with spleen.
- Jia Wei Xiao Yao San (Bupleurum and Paeonia Formula, Item No. 2068): It treats the liver stagnation plus t e interior heat.
(2). Depressive Syndrome due to the Combined Stagnated Qi and Fire:
Indications: Restlessness, easily angered, fullness of chest and hypochondriac area, acid regurgitation, dry and bitter mouth, constipation, or headache, red and irritated eyes, tinnitus, red tongue, yellow coating, wiry and rapid pulse.
Treatment & Formulas: Clear the stagnated fire and harmonize the liver.
- Jia Wei Xiao Yao San (Bupleurum and Paeonia Formula, Item No. 2068)
- Yi Gan San (Bupleurum Formula, Item No. 2105) Long Dan Xie Gan Tang (Gentiana Combination, Item No. 2267): This is a strong formula to clear the liver and gallbladder fire plue the interior damp -heat factors.
(3). Depressive Syndrome due to the Combined Qi and Phlegm:
Indications: Uncomfortable and blockage sensation at throat, the obstructive feeling at throat can not be relieved by swallowing in or vomiting, fullness of chest, or pain at hypochondriac area, white and greasy coating, wiry and rolling pulse.
Treatment & Formulas: Regulate Qi, resolve phlegm and harmonize the liver.
- Ban Xia Hou Po Tang (Pinellia and Magnolia Combination, Item No. 2064): This is the typical formula to treat the globus systericus, or other symptoms caused by the stagnated Qi combined with phlegm.
- Wen Dan Tang (Bamboo and Hoelen Combination, Item No. 2228): This treats those symptoms with vomiting and other signs of phlegm-heat.
2. Depressive Syndrome of Xu (Deficiency) Type:
(1 ). Depression Disturb the Mind:
Indications: Mindlessness, moody, restlessness, sadness with strong desire to cry, frequent sighing, insomnia, white and thin coating, wiry and thready pulse.
Treatment & Formulas: Tonify the heart and soothe the unstable mind.
- Gan Mai Da Zao Tang (Licorice and Jujube Combination, Item No. 2294): This is a very famous formula from the book called Jin Gui Yao Lu (The Synopsis of Golden Chamber) by Dr. Zhong Jing Zhang of Han dynasty (about 200 AD.). Its indications are called Zhang Zao in Chinese, they are a group symptoms of hysteria, mania, convulsions.
- Chai Hu Jia Long Gu Mu Li Tang (Bupleurum and Dragon Bone Combination, Item No. 2154): This is another very effective formula from the same book of Zhong Jing Zhang to tranquilize the unstable mind and emotions.
- Gui Zhi Jia Long Gu Mu Li Tang (Cinnamon and Dragon Bone Combination, Item No. 2163): Another formula for mind tranquilizing for the delicate body type.
(2). Depression Syndrome due to the Deficiency of Heart and Spleen:
Indications: Excessive thinking, easy to have worry and fearful emotions, palpitation, insomnia, forgetfulness, pale face, dizziness, fatigue, poor appetite, pale tongue, thin coating, thready and weak pulse.
Treatment & Formulas: Tonify the heart and spleen, strengthen the Qi and blood.
(3). Depressive Syndrome due to the Upflamlng of Deficient Fire:
Indications: Dizziness, palpitation, insomnia, restlessness, easily angered, or emission, sore and weak lumbar regions, or irregular menstruation, red tongue, wiry, thready and rapid pulse.
Treatment & Formulas: Tonify the Yin so as to clear heat, tranquilize mind.
- Ji Ju Di Huang Wan (Lycium, Chrysanthemum and Rehmannia Six Formula, Item No. 2290): This tonifies the kidney Yin so as to clear the deficient fire.
- Tian Wang Bu Xin Dan (Ginseng and Zizyphus Formula, Item No. 2055): It treats the hysteria, emotional instability, insomnia, mental exhaustion by tonifying the Yin of heart and kidney clearing the deficient fire and soothing the disturbed mind.