Visceral agitation

From Essential Prescriptions of the Golden Cabinet (金匮要略 jīn guì yào lüè, fù rén zá bìng mài zhèng bìng zhì piān). A paroxysmal mental disease most prevalent in women, heralded by melancholy and depression, illusions, emotionalism, and increased or diminished sensitivity. Attacks are characterized by vexation and oppression, rashness and agitation, sighing for no apparent reason, and sadness with an urge to weep. In severe cases, there may be convulsions, which, unlike those occurring in epilepsy, are accompanied by a white complexion or complete loss of consciousness. Visceral agitation falls into two basic patterns, heart spirit deprived of nourishment and insufficiency of the liver and kidney.

Biomedical correspondence: hysteria.

Patterns

Heart spirit deprived of nourishment (心神失养 xīn shén shī yǎng) arises when worry or thought damage the heart and excessive taxation fatigue damages the spleen. The resultant condition of dual damage to the heart and spleen and insufficiency of qì and blood deprives the heart spirit of nourishment. When the heart is deprived of nourishment, the heart spirit fails to be stored and spirit qì runs amok. Signs include devitalized essence-spirit, abstraction, sorrowfulness without apparent cause and abnormal laughing and crying. There may also be vexation, insomnia, profuse dreaming, susceptibility to fright, heart palpitation, lassitude of spirit, thirst, constipation, red tongue that may be soft in texture, and a weak fine or fine stringlike pulse.

Medicinal therapy: Enrich and supplement with sweet moist medicinals and nourishing and quieting the spirit. Use Licorice, Wheat, and Jujube Decoction (甘麦大枣汤 gān mài dà zǎo tāng) plus spiny jujube (Ziziphi Spinosi Semen, 酸枣仁 suān zǎo rén), dried/fresh rehmannia (Rehmanniae Radix, 生地黄 shēng dì huáng), and lily bulb (Lilii Bulbus, 百合 bǎi hé).

Acumoxatherapy: Base treatment mainly on HT, GV, and PC. Main points: GV-26 (Water Trough, 水沟 shuǐ gōu), GV-20 (Hundred Convergences, 百会 bǎi huì), PC-6 (Inner Pass, 内关 nèi guān), and HT-7 (Spirit Gate, 神门 shén mén). For heart spirit deprived of nourishment, add BL-15 (Heart Transport, 心俞 xīn shù), PC-8 (Palace of Toil, 劳宫 láo gōng), SP-10 (Sea of Blood, 血海 xuè hǎi), and SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo); needle with supplementation.

Point selection according to signs: For abnormal laughing and weeping, add SI-3 (Back Ravine, 后溪 hòu xī). For essence-spirit abstraction, add BL-15 (Heart Transport, 心俞 xīn shù) and BL-47 (Hun Gate, 魂门 hún mén).

Insufficiency of the liver and kidney (肝肾不足 gān shèn bù zú) arises when childbirth or severe illness causes depletion of the blood and can cause visceral agitation if the heart and liver are deprived of nourishment and effulgent qì and blood disquiet the heart spirit and prevent the ethereal soul from being stored. It is characterized by the similar heart spirit signs (insomnia, heart palpitation, susceptibility to fright) and heat signs (dry mouth, red tongue, dry stool) as the previous pattern. However, In addition, there are distinctive kidney vacuity signs such as heat in the hearts of the palms and soles, tinnitus, and limp aching lumbus and knees, as well as liver vacuity signs such as vexation and irascibility.

Medicinal therapy: Treat insufficiency of the liver and kidney by enriching the kidney and clearing the liver and by nourishing the heart and quieting the spirit. Use Lily Bulb and Rehmannia Decoction (百合地黄汤 bǎi hé dì huáng tāng) combined with Water-Enriching Liver-Clearing Beverage (滋水清肝饮 zī shuǐ qīng gān yǐn). If there are signs of binding depression of liver qì such as affect-mind depression, and oppression in the chest with qì counterflow, plum pit qì, and rib-side pain, use Free Wanderer Powder (逍遥散 xiāo yáo sǎn) or Bupleurum Liver-Coursing Powder (柴胡疏肝散 chái hú shū gān sǎn), adding moutan (Moutan Radicis Cortex, 牡丹皮 mǔ dān pí) and gardenia (Gardeniae Fructus, 山栀子 shān zhī zǐ) if the depression is transforming into fire.

Acumoxatherapy: Use the main points given above, and add PC-8 (Palace of Toil, 劳宫 láo gōng), CV-4 (Pass Head, 关元 guān yuán), KI-1 (Gushing Spring, 湧泉 yǒng quán), LR-3 (Supreme Surge, 太冲 tài chōng), LR-2 (Moving Between, 行间 xíng jiān), and SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo); needle with even supplementation and drainage. For liver depression and qì stagnation, add TB-6 (Branch Ditch, 支沟 zhī gōu), LR-3 (Supreme Surge, 太冲 tài chōng), and LR-2 (Moving Between, 行间 xíng jiān); needle with drainage or with even supplementation and drainage. If there is transformation into fire, drain GB-43 (Pinched Ravine, 侠溪 xiá xī) and GB-34 (Yáng Mound Spring, 阳陵泉 yáng líng quán).

Point selection according to signs: For oppression in the chest and counterflow qì, add CV-17 (Chest Center, 膻中 shān zhōng) and ST-40 (Bountiful Bulge, 丰隆 fēng lóng).

Etymology

Chinese: zàng, viscus, explained in this context as referring to the heart viscus or the child’s viscus (uterus); zào, agitation, said to refer to agitation of the blood due to damage to yīn or to impatience and agitation.