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My experience in treating mental diseases (reformed variant)

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Post time: 2009-04-28 10:56:38
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I have not enough practice in sending post to Forum, so I found that in my last post (“My experience in treating mental diseases”, posted: Thu Feb 10, 2005 7:21 am to Acupuncture Forum) instead of arrows (I used them to show superfluity or deficiency) somebody can see only squares. So I’m sending reformed variant. Sorry!

I’m always watching publications in Medboo Forum. It is so interesting and gives very important information! 07.02.05 I read article “Acupuncture for Treating Mental Diseases” with request “read it and give your idea about it, what's your experience?” I’m understood that this request addressed to specialists, and I’m not Master, I’m only studying TCM. But during more then 20 years I tried to treat different physical and mental disorders by means of acupressure (I mean massage of acupoints) and Chinese massage Tui Na with good results in most cases. May be my experience (in spite of possible mistakes) will be interesting to somebody. Moreover, I’ll be appreciating for every censorious remark.
In this post I tried to describe some cases from my practice. By way of illustration I choused causes of insomnia and depression. I included also 2 cases of epilepsy in conventional medicine describing in part of neurological disorders.
In each pair of cases I found opposed reasons for the same symptom: for example, insomnia with liver-heat or deficiency of the liver-Yin; depression with deficiency of heart or heart-heat; epilepsy with liver and kidney deficiency or the same disease with excess in liver and kidney.
To shorter description I used symbols H (high) and L (low) to show superfluity or deficiency in Meridians (I’m realize that it is too pared-down interpretation) or R for reducing and S (strengthening) for reinforcing methods.
Each treatment I started from diagnostic, based on my knowledge of the Four Diagnostic Methods of TCM. During conversation and questioning and while a treating, it was actually of paramount importance to get into contact with a patient “to find out the root causes of the diseases” and “to relieve the psychological disturbance of the patients”.
Each treatment consisted in:
• main part of acupoints massage (different at each stage of treatment) and following moxibustion or infrared heating or using red laser;
• auxiliary part of Tui Na massage, foot massage, scalp massage, massage with aromatic oils, Shiatsu massage or other methods – all of them individually to each case and at each treatment. (In this post I’m describing only Tui Na);
• part of recommendations for herbal treatment (in most cases herbs were used in form of tinctures – alcoholic extracts because of nearly each of patients preferred ready tinctures to decocting herbs);
• part of recommendations for mode of life, nutrition (for example, for patient with a hot temper and liver-heat recommendation to lower hot, spicy and sour food), for Taiji, QiGong (many patients after recommendations started practice it in a special groups for years and these methods helped them to retain stability.)
Such points as Hegu (LI4) and Zusanli (ST36) were effective in each case of mental diseases and I often used them in first treatments.
In my practice I saw that most effective course of treatments consists from 7 treatments, first four of them each 2 – 3 days, other three 1 time in a week. Usually one course was enough to achieve stable improvement. (I have observation for at least 4 – 5 years). Duration of treatments was 2 hours for first treatment and 1.5 hour for the next ones. Improvement generally started from initial treatments, but after 3rd treatment as a rule was short impairment, after whereupon patient’s state improved and stabilized during next 4 treatments. Even one case of drug (opioid) dependence was successfully treated during course of 7 treatments. This patient (62 years old) suffered from severe headache for about 15 years. During last 3 years he was treated by morphine (20 mg 2 – 3 times in a day). In spite of this treatment he suffered from everyday headache and insomnia. During a course of treatments his state improved and he gradually stopped to take morphine.
In cases of epilepsy course of treatments was longer (sometimes till 6 month: 2 times in a week first 4 treatments, 1 time in a week during next 1 – 2 month and 1 time in two weeks after that).
I think that two methods helped me to shorter course of treatments: gluing (with plaster) on acupoints small steel bolls (3 mm in diameter) and recommendation for self-massage of acupoints.

1. Insomnia:
LR (H) - Patient I. P. (state of other Meridians: SJ(H), HT(H), SP(L) ). Shi was falling asleep easily, sleeping without dreams, but easy to be wakening up at 1 a.m. (Liver Meridian?) The patient had a hot temper. The accompanying symptoms were distention in the eyes, irritability, bitter taste in the mouth, pain in right hypochondriac region, constipation, palpitation and tendency to hypertension. (Is this a case of disturbed mind by liver-heat?)
• Main part of acupoints massage:
To balance energy between pairs Yin and Yang Meridians:
Chongyang (ST42)(R) - Gongsun (SP4)(S), Sanyinjiao (SP6);
To lower liver-heat: Xingjian (LR2), Taichong (LR3), Yangfu (GB38), Fengchi (GB20);
To lower a common heat: Huizong (SJ7), Zhigou (SJ6), Waiguan (SJ5);
To appease the mind: Shenmen (HT7), Hegu (LI4), Quchi (LI11), Zusanli (ST36), Baihui (DU20);
To lower inner physical (hypertension, palpitations) and mental (irritability) pressure: Neiguan (PC6);
• Auxiliary part of Tui Na: area Yintang (Ex-HN3) - from Yintang (Ex-HN3) to front hairline, then horizontally from Yintang (Ex-HN3) to Taiyang (Ex-HN5). (This massage was very effective in cases of mental disorders, dizziness; when followed by massage from Taiyang (Ex-HN5) to Touwei (ST8) and then to Fengchi (GB20) was helpful in the end of headache treatment to relieve residual pain).
• Herbal treatment: Valeriana officinalis, Passiflora incarnata, Melissa officinalis, Crataegus sanguinea, Calendula officinalis.
• Aromatic oils: Lavender (really universal oil!), Ylang-Ylang.

LR (L) - Patient M. B. (state of other Meridians: LU(H), PC(H), SJ(L)). The patient suffered from insomnia for about 20 years. He usually had a dream-disturbed sleep, easy to be wakening up (at 4 a.m.), which went worse in recent two years. He could only sleep for 4 hours each night. The accompanying symptoms were depression, fatigue, in medical history hernia and enuresis. (Is this a case of deficiency of the liver-Yin, with stirring-up of endogenous wind of the deficiency type?)
• Main part of acupoints massage:
• To lower energy in Lung Meridian (wakening up at 4 a.m.): Taiyuan (LU9), Chize (LU5);
To balance energy between pairs Yin and Yang Meridians: Daling (PC7) (R) - Waiguan (SJ5)(S), Qiuxu (GB40)(R) - Ligou (LR 5)(S), Taichong (LR3);
To lower inner physical and mental pressure: Neiguan (PC6), Laogong (PC8) (the last point was very helpful in cases of fatigue, irritable weakness);
To tranquilize the mind: Shenmen (HT7), Hegu (LI4), Baihui (DU20), Yintang (Ex-HN3);
• Auxiliary part of Tui Na: area Yintang (Ex-HN3) - from Yintang (Ex-HN3) to front hairline, then horizontally from Yintang (Ex-HN3) to Taiyang (Ex-HN5).
• Herbal treatment: Eleutherococcus senticosus (it shown more gentle reinforcing effect then Panax ginseng), Valeriana officinalis, Passiflora incarnata, Leonurus quinquelobatis, Silibum marianum, Glycyrrhiza glabra, Hypericum perforatum.
• Aromatic oils: Lavender, Neroli (this oil was very effective for depression treatment).

2. Depression:
HT (L) - Patient Ch. Ch. (state of other Meridians: SP(L), KI(L), BL(H), SI(H) ). The patient (72 years old) suffered from fatigue, insomnia, amnesia, severe depression (with low weeping in a morning) during 9 years after death of his wife. The accompanying symptoms were diabetes, prostatitis, impotence, pain in lower back after sleeping. (Is this a case of deficiency of heart and spleen caused by excessive thinking and worrying?)
• Main part of acupoints massage:
To balance energy between pairs Yin and Yang Meridians: Wangu (SI4)(R) - Tongli (HT5)(S), Shenmen (HT7), Chongyang (ST42)(R) - Gongsun (SP4)(S), Sanyinjiao (SP6), Yinlingquan (SP9), Jinggu (BL64)(R) - Dazhong (KI4)(S), Taixi (KI3), Zhaohai (KI6), Shenmai (BL62);
To treat weeping in a morning: LU5 (this point was very helpful in cases of depressive weeping);
To treat fatigue: Zusanli (ST36), Hegu (LI4);
• Auxiliary part of Tui Na: massage of neck and upper back.
• Herbal treatment: Valeriana officinalis, Crataegus sanguinea, Laurus nobilis
• Aromatic oils: Lavender, Neroli, Rosemary.
HT (H) - Patient D. W. (state of other Meridians: SP(H), PC(H)). The patient suffered from fatigue, depression, irritability. The accompanying symptoms were diarrhea, pain in right hypochondriac region, palpitation and tendency to hypertension, metrorrhagia; in medical history cholecystitis, attempt suicide. The patient had a hot temper, red tongue. (Is this a case of flaring of fire resulting from Yin deficiency?)
• Main part of acupoints massage:
To lower inner physical and mental pressure: Hegu (LI4), Quchi (LI11), Laogong (PC8), Neiguan (PC6);
To appease the mind: Shenmen (HT7), Shaohai (HT3), Jiuwei (RN15) + Houding (DU19) (combination of two last points were effective to balance the mind);
To treat irritability and menstrual disorders: Taichong (LR3), Sanyinjiao (SP6), Diji (SP8), Yinlingquan (SP9), Yongquan (KI1), Zhaohai (KI6);
To treat fatigue: Zusanli (ST36), Guanyuan (RN4)
• Auxiliary part of Tui Na: at the same time from Baihui (DU20) forward to Shenting (DU24) and backwards to Yamen (DU15) (this massage was very helpful in cases of hypertension).
• Herbal treatment: Valeriana officinalis, Leonurus quinquelobatis, Silibum marianum, Crataegus sanguinea, Vaccinium myrtillus.
• Aromatic oils: Lavender, Neroli, Lemon.

3. Epilepsy:
In both cases of epilepsy results of EEG were identical (!)
LI (L), KI (L) - Patient D.V. (state of other Meridians: GB(H), BL(H), HT(H), LU(H), ST(L)). The patient (10 years old) suffered from epilepsy for about 7 years. Seizures (for about 1 min.) were as a rule at 4 – 5 a.m. (Lungs Meridian?) The accompanying symptoms were mental retardation, in medical history sleep disturbance before seizures starting.
• Main part of acupoints massage:
To balance energy between pairs Yin and Yang Meridians: Qiuxu (GB40)(R) - Ligou (LR 5)(S), Taichong (LR3) )(S), Yangfu (GB38), Zulinqi (GB41), Yuanye (GB22), Jinggu (BL64)(R) - Dazhong (KI4) )(S), Taixi (KI3) )(S), Shenmai (BL62), Shugu (BL65), Kunlun (BL60),
To tranquilize the mind: Shenmen (HT7), Zhongji (RN3), Shimen (RN5), Juque (RN14), Baihui (DU20) + Sishencong (EX-HN1) (combination of DU20 and EX-HN1 gives very fast result);
To lower energy in Lung Meridian (seizures at 4 – 5 a.m.): Taiyuan (LU9), Chize (LU5).
• Auxiliary part of Tui Na: massage along three lines: from Yintang (Ex-HN3) to Baihui (DU20) and from Yangbai (GB14) to Luoque (BL8) symmetrically on two sides of head.
• Herbal treatment: Valeriana officinalis, Passiflora incarnata, Melissa officinalis.
• Aromatic oils: Lavender, Melissa, Chamomile.
LI (H), KI (H) - Patient G.E. (state of other Meridians: SP(H), PC(H)). The patient (16 years old) suffered from epilepsy (localized twitching of muscles – jacksonian seizure) 2 – 10 times in a day (in a morning or afternoon only) for about 1 year. The accompanying symptoms were nape and back rigidity, retardation of sexual development (menstruation from age 15.5, irregular).
• Main part of acupoints massage:
To lower muscle tension and stimulate sexual development:
Taichong (LR3)(R), Xingjian (LR2), Ligou (LR 5), Hegu (LI4), Quchi (LI11), Sanyinjiao (SP6), Sangqui (SP5), Yinlingquan (SP9), Yongquan (KI1)(R), Taixi (KI3), Zhaohai (KI6);
To lower inner physical and mental pressure: Laogong (PC8), Neiguan (PC6);
To appease the mind: Shenmen (HT7), Shao-hai (HT3), Dazhui (DU14).
• Auxiliary part of Tui Na: massage of neck and upper back.
• Herbal treatment: Valeriana officinalis, Passiflora incarnata, Crataegus sanguinea.
• Aromatic oils: Lavender, Melissa, Geranium.
• Relaxation exercises.

I’m sorry for my mistakes and incorrect terminology, but “I’m not magician yet, I still studying”.

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Post time: 2009-04-28 10:56:49
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A great experience!!!
Thank you very much Sophia!
You are indeed a SPECIALIST yourself and have VERY good experience. Moreover, you have made good generalization as well.
I would say a few words about my opinions on what you have done. It's only my feeling, not the comments,
To treat insomnia, you have mentioned acupoints Hegu (LI 4) and Zusanli (ST 36), I also suggest the combination between Hegu (LI 4) and Taichong (LR 3), which are known as the "Four-Gate points". So when you open the gate, there will be better running of air, so the Qi would move more smoothly. Apparently this is especially good for cases of Qi stagnation. For sure they are indeed helpful for those with hot temper. But for depression, they can also help.
For drug addiction, I think first of all is to calm down the mind. As we all know, the addiction is not only because of the physical effect of the drugs, but more because of the mental side.
For the chronic cases of epilepsy, I found that many cases are of the syndrome of Qi and blood deficiency or the hypoactivity of spleen and stomach thus there could be damp-phlegm, especially the phlegm. So the patient may look thin, but his/her complexion is pale, extremities cold, spirit low, and they may often feel dizzy. So, we should try to eliminate the phlegm, so please don't forget Fenglong (ST 40).
Ok, that's what I can say so far. Maybe I would tell more about my opinions later.
What's the opinions of the other friends?

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Post time: 2009-04-28 10:57:03
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I’m really happy to receive so flattering opinion!
Now I have even greater energy to work and to study.
Thank you for your comments, your experience is very important to me.
With respect to point Taichong (LR 3) it was actually the most useful point to treat insomnia for patients with hot temper and insomnia in a middle of the night. I’ll try to use it for depression as well. I’ll add to my arsenal your other comments too: about drug addiction (you are absolutely right!) and regarding point Fenglong (ST 40).
I’m waiting impatiently for new comments and censorious remark and still studying…

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Post time: 2009-04-28 10:57:14
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I also noticed that you take the time of the occurrence or seizures of diseases very much into your consideration! That's very good!
Many physicians of traditional Chinese medicine would ignore this point, so losing a important factor for the cure.
However, you'd better not be limited by the timing only, neither by the Five-Shu points, try to find your own experience, and take the Five-Shu points only as reference, for they are not as reliable as the books said.
It's only my personal opinion on the Five-Shu points, certainly there should be some different opinions against me, so all the comments and critisim are welcome!!! I don't mind being pasted with criticising comments and remarks!

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Post time: 2009-04-28 10:57:27
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First, thanks a lot for that great post, Sophia! I hope you don't mind me using your research to help people on my part of the world

I have a comment/inquiry.

In treating mental diseases I would also include the points on the second (outter) line of the Bladder channel. Specifically, points like Po Hu (BL42) for depression or depression-related insomnia, and Hun Men (BL47) for epilepsy, and the other points on that same line which have influence over the spiritual functions of the organs (po, hun, yi, zhi, and shen).

Considering the brain is related to the five organs through their spiritual functions, I would think such points would be very helpful, almost obligatory, for mental illnesses.

But reading the Dr. King's comment that the five shu points are not perfectly reliable, and neither Dr. M.H. nor Sophia mentioning them makes me think twice.

What are your thoughts on the "spiritual function" acupuncture points?

For mental diseases I use scalp acupuncture. It's the only thing I ever plan to use scalp acupuncture for (I still feel more comfortable with whole-body or ear acupuncture), but it seems to work well on mental/neurological diseases.

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Post time: 2009-04-28 10:57:40
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HI, Serpent,
Acupoints should be well indicated to the mental disorders, or the neurological diseases, but don't try to find the "spiritual functions" of them,
the spirit is mainly from you!
Scalp acupuncture is good for some neurological diseases.
Some conventional points are related with the spirit, but not all of them, and the ones on the second line of Bladder meridian don't mean anything definitely in connections with the spirit despite of the beautiful names of mentality of spirit.
Any other opinions on this point? All the comments are welcome.

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Post time: 2009-04-28 10:57:55
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[quote:78eb21f224="Feathered Serpent"]First, thanks a lot for that great post, Sophia! I hope you don't mind me using your research to help people on my part of the world

I have a comment/inquiry.

In treating mental diseases I would also include the points on the second (outter) line of the Bladder channel. Specifically, points like Po Hu (BL42) for depression or depression-related insomnia, and Hun Men (BL47) for epilepsy, and the other points on that same line which have influence over the spiritual functions of the organs (po, hun, yi, zhi, and shen).

Considering the brain is related to the five organs through their spiritual functions, I would think such points would be very helpful, almost obligatory, for mental illnesses.

But reading the Dr. King's comment that the five shu points are not perfectly reliable, and neither Dr. M.H. nor Sophia mentioning them makes me think twice.

What are your thoughts on the "spiritual function" acupuncture points?

For mental diseases I use scalp acupuncture. It's the only thing I ever plan to use scalp acupuncture for (I still feel more comfortable with whole-body or ear acupuncture), but it seems to work well on mental/neurological diseases.[/quote:78eb21f224]

Hi, Serpent,
Last night I thought of the toxins in the liver, resulting from the stagnation of liver Qi, but couldn't reason out how to explain it, and this morning I found out the clue, so I think the stagnation of liver Qi could be compared as the stagnant water in one place, so the water would become poisonous, and you see the poisonous water? So in the body it would become cancer.

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Post time: 2009-04-28 10:58:08
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Today in the morning (for me it’s a morning) I read post of Dr. King in Acupuncture Forum and thought that he is absolutely right.
My first education is biochemistry, so I know that liver is a center of biochemical reactions in the body: hormone synthesis and inactivation, poisonings inactivation and so on. Actually, when Liver Qi is stagnated, it becomes be poisonous. In the other hand, it is possible that tendency to increasing of cholesterol levels in the last time is not indication of “disease of our century”, but defense reaction in century of a stress. Cholesterol, which synthesizes in liver, is a basic molecule to steroid production, you know. So, may be physicians of Western medicine make a blunder trying to reduce cholesterol level too much without find out the root causes this. By the way syndrome of chronic fatigue with low cholesterol levels and signs of depression is known now (deficiency of Liver Qi?).

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Post time: 2009-04-28 10:58:21
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Dear Sophia,
It's so nice to see you new post!
I agree with you that there should be the deficiency of liver Qi. But at the moment in China, there is still debate on this point. Some physicians and scholars insist that there must be liver Qi deficiency and the others argue that liver Qi is never deficient, it should be the deficiency of Qi of other organs or it's only the liver blood deficiency.
Personally I had the experience of overdosed Qigong practice for soothing liver Qi. You know the so called soothing of liver Qi is a kind of reducing, so I know the feeling of what the liver Qi deficiency is.
Maybe some people don't believe me and have the opposit opinions, it's always to welcome the opposite remarks from our friends herein.

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Post time: 2009-04-28 10:58:34
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[quote:9541516f12="David King"]
Some physicians and scholars insist that there must be liver Qi deficiency and the others argue that liver Qi is never deficient, it should be the deficiency of Qi of other organs or it's only the liver blood deficiency.
[/quote:9541516f12]

I was taught the second theory, that liver Qi is never deficient.

But considering nothing in life is absolute (if are to believe the yin/yang theory), the Liver cannot be entirely and absolutely inclined towards excess. I always thought cases of liver Qi deficiency [i:9541516f12]had[/i:9541516f12] to exist, even if they were rare.

On the other hand, maybe in practice, a Liver Qi deficiency is so rare one could say it [i:9541516f12]practically[/i:9541516f12] (but not [i:9541516f12]absolutely[/i:9541516f12]) doesn't exist.

[quote:9541516f12="Sophia"]By the way syndrome of chronic fatigue with low cholesterol levels and signs of depression is known now (deficiency of Liver Qi?).[/quote:9541516f12]

Those symptoms indeed look like a deficiency of Qi, now that you mention it, Sophia. Maybe when the idea that Liver Qi deficiency was impossible came out, it was because very few people had those symptoms (not considering a low cholesterol level, of course, which I imagine nobody knew abour prior to the 20th century!) because stress was perhaps much lower before, say, the industrial revolution during the 19th century.

Could it be that the level of stress these days is higher than it's ever been in most of the history of humanity, so that a deficiency of Liver Qi is now actually fairly common?

So, in my opinion, there are three possibilities:
[list:9541516f12]
-Liver Qi deficiency exists, it is rare but must be taken into account.
-Liver Qi deficiency exists, but it is so rare it doesn't matter.
-Liver Qi deficiency exists. It wasn't very common before the 19th or 20th century, but now it definitely is.
[/list:u:9541516f12]

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