Case Study: Anxiety Neurosis

TRADITIONAL CHINESE MEDICAL DIAGNOSIS

Etiology:

The Shen encompasses man's emotional and mental aspects. It includes the thought process component of mental function (logic, coherence, etc.), affect (feelings expressed through voice, expression, etc) and mood (a sustained emotion). Through an adequate supply of Yin and Blood, the Heart houses the Shen. If these are deficient the Shen has no root and becomes Disturbed. The patterns of Blood Deficiency, Yin Deficiency or Disturbed Shen may cause anxiety. Conversely, anxiety can injure the Blood, Yin or Shen.

Also, it is said that the Liver governs the emotions, mental balance and conduct. Stagnation of Liver Qi can disrupt the smooth flow of emotions.

Important etiological factors include improper diet or malnourishment, a long duration of anxiety and worry, a busy lifestyle, or severe hemorrhage. Emotional disharmony (eg. frustration, repressed anger, or prolonged resentment) is the main factor in Liver Qi Stagnation.

Diagnoses according to the Eight Principles:

Yin / Interior / Deficiency / Heat

Traditional Chinese Medical Diagnosis:

Insomnia with dream disturbed sleep indicates Disturbed Shen. A thin pulse, pale tongue and low energy are signs of Blood Deficiency. The wiry aspect of the pulse and the "churning stomach" point to the Liver attacking a weak Middle Jiao.

These signs and symptoms together lead to a diagnosis of: Spleen Deficiency leading to Blood Deficiency and Disturbed Shen, with the Liver Attacking the Middle Jiao.

TREATMENT PRINCIPLE AND PLAN

Treatment Principle: Tonify the Spleen in its function of producing Blood. Calm the Shen. Smooth the Liver and protect the Middle Jiao.

Acupuncture Points:

St 36	Zusanli	Tonifies Spleen. Tonifies Qi and Blood
Sp 6	Sanyinjiao	Strengthens Spleen, Tonifies Yin and Blood, Smooths Liver Qi
Ren 6	Qihai	Tonifies and Regulates Qi
Pc 6	Neiguan	Calms the Shen, Regulates Qi, Luo Point
Ht 7	Shenmen	Calms the Shen, Source Point
Du 20	Baihui	Calms the Shen, Lifts the Spirits
Ear	Shenmen	Calms the Shen

St 36, Sp 6, Pc 6, and Ht 7 were needled bilaterally. Ear Shenmen was needled on the right. All needles were Seirin #5. Needles were retained for 20 minutes.

Chinese Herbs:

The formula, Gui Pi Tang Chia Wei which strengthens Heart and Spleen, and Calms the Shen. Ingredients:

Added to Gui Pi Tang:

Omitted from Gui Pi Tang: