Depression pattern

1. Any pattern of qì stagnation (frustration of normal physiological activity). Plain Questions (素问 sù wèn, liù yuán zhèng jì dà lùn) speaks of wood depression, fire depression, earth depression, metal depression, and water depression. These were later called the five depressions. Dān-Xī’s Heart-Approach (Zhū Zhèn-Hēng 朱震亨 [Dān-Xī 丹溪], 丹溪心法 dān xī xīn fǎ) describes qì depression, blood depression, damp depression, heat depression, phlegm depression, and food depression, which together are known as the six depressions. Jing-Yue’s Complete Compendium (景岳全书 jǐng yuè quán shū) speaks of depression caused by affect-mind depression: anger depression, thought depression, worry depression, sorrow depression, fright depression, and fear depression. Mysterious Pearl of Red Water (赤水玄珠 chì shuǐ xuán zhū) puts forward the notion the qì of the five viscera could become depressed, and speaks of heart depression, liver depression, earth depression, lung depression, kidney depression, and gallbladder depression. See depression¹.

2. Specifically, any pattern arising when constrained affect-mind causes binding depression of qì dynamic, and characterized by mental depression, oppression in the chest, and rib-side pain. When liver qì runs cross counterflow and restrains the spleen, signs include abdominal distension, belching, no thought of food and drink, and a fine stringlike pulse. When depressed qì transforms into fire, and liver fire ascends counterflow, signs include headache, dizziness, oppression in the chest and rib-side distension, bitter taste in the mouth, dry mouth, red tongue with yellow fur, and a pulse that is usually rapid and stringlike. When phlegm and qì become depressed and bound, there is a feeling of blockage in the throat that can neither be expectorated nor swallowed.

Medicinal therapy: Liver qì running cross counterflow is treated by coursing the liver and rectifying qì with Counterflow Cold Powder (四逆散 sì nì sǎn). Depressed qì transforming into fire is treated by clearing and draining liver fire with Supplemented Free Wanderer Powder (加味逍遥散 jiā wèi xiāo yáo sǎn). Binding depression of phlegm and qì is treated by disinhibiting qì and transforming phlegm with formulas such as Pinellia and Officinal Magnolia Bark Decoction (半夏厚朴汤 bàn xià hòu pò tāng) or Gallbladder-Warming Decoction (温胆汤 wēn dǎn tāng).

Acumoxatherapy: Base treatment on PC, LR, and SP. Main points: PC-6 (Inner Pass, 内关 nèi guān), LR-3 (Supreme Surge, 太冲 tài chōng), and SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo).

• For depressed liver qì, add BL-18 (Liver Transport, 肝俞 gān shù), BL-17 (Diaphragm Transport, 膈俞 gé shù), LR-14 (Cycle Gate, 期门 qī mén), and ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), needling with even supplementation and drainage.
• For depressed qì transforming into fire, add GB-34 (Yáng Mound Spring, 阳陵泉 yáng líng quán), LR-2 (Moving Between, 行间 xíng jiān), PC-8 (Palace of Toil, 劳宫 láo gōng), and KI-1 (Gushing Spring, 湧泉 yǒng quán), needling with drainage.
• For binding depression of phlegm and qì, add CV-17 (Chest Center, 膻中 shān zhōng), ST-40 (Bountiful Bulge, 丰隆 fēng lóng), and CV-22 (Celestial Chimney, 天突 tiān tú), needling with drainage.

Biomedical correspondence: These pattern are observed in neurosis, hypertension, chronic gastritis, and ulcers of the digestive tract.