Chapter Sixteen. Substances that sedate the Spirit and calm the Mind
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1. What are the indications for the substances that sedate the Spirit and calm the Mind?
The substances that sedate the Spirit and calm the Mind are able to treat restlessness, anxiety, palpitations, irritability, insomnia and emotional distress. The symptoms are directly caused by disturbance of the Heart, which is the residence of the Spirit, and determines the emotional, mental and spiritual features of the individual. The syndrome of Heart-Spirit disturbance can primarily be subdivided into the syndromes of Excessive-Heat and Blood deficiency.
In the Excessive-Heat syndrome, the symptoms have a pronounced and aggressive feature. Rage and stress may, in a very short time, cause Liver-Qi stagnation, Liver-Fire blazing upwards or Liver-Yang rising that influence the Heart immediately. Meanwhile, the Heart-Yin can be directly injured by Heat in many infectious diseases, which in Chinese medicine are considered as febrile diseases. Some chronic diseases often consume the Heart-Yin too. All these factors cause the Heart-Fire to blaze up, which disturbs the Spirit and leads to anxiety, irritability, palpitations, difficulty in falling asleep and dream-disturbed sleep.
In the syndrome of Blood deficiency, the symptoms have a mild and chronic feature. Since the state of the Heart-Spirit is based on sufficient Blood, when there is Blood deficiency there are symptoms such as restlessness and fear without any reason, emotional distress, palpitations, frequent sweating or night sweats, dream-disturbed sleep or frequent waking up at night. The tongue body is usually pale or delicate red with a thin white coating and the pulse is often thready, weak and restless.
In clinical practice, the syndromes are often more complicated. The Excess is often complicated with the Deficiency, and all the outlined symptoms may be present simultaneously. Therefore it may be necessary to sedate the Spirit, reduce Fire or direct the Liver-Yang to descend, as well as tonify the Blood and Yin of the body.
2. What are the characteristics of the substances that sedate the Spirit and calm the Mind? What precautions should be observed when using them?
The substances that sedate the Spirit and calm the Mind can be divided into two groups. One group focuses on sedating the Spirit; these substances can control the symptoms quickly. They are mainly used in acute situations and especially in an Excessive syndrome. A second group deals with the causes and the manifestations of the syndrome; these substances have the function of tonifying the Blood and Yin, reducing the Heat from the Heart and calming the Mind. They are used for a chronic or mild syndrome.
The substances that sedate the Spirit and calm the Mind have the following characteristics.
Entering the Heart, Liver and Kidney meridians
The five internal organs are connected with the seven emotions. Of these emotions, the symptoms of restlessness with anxiety, difficulty in falling asleep and palpitations are linked with the Heart; irritability, insomnia and dream-disturbed sleep are linked with the Liver; restlessness and fear with anxiety are linked with the Kidney. Most of the substances that sedate the Spirit and calm the Mind enter the Heart, Liver and Kidney meridians; therefore they control the disorders from different aspects.
Many mineral substances
Mineral substances in TCM are considered to have a descending nature because they are heavier in weight and more solid than the herbs. Heaviness can sedate the Spirit, descend the Yang and Fire, and control fear. They are often used for treating acute or Excessive conditions. The commonly used substances are Ci Shi ( Magnetitum), Zhen Zhu ( Margarita usta), Zhen Zhu Mu ( Concha margaritifera usta), Zi Shi Ying ( Fluoritum), Hu Po ( Succinum), Long Gu ( Mastodi fossilium ossis) and Mu Li ( Ostrea concha).
Cold and salty
Since most of the acute cases of mental disturbance are caused by Excessive- or Empty-Fire, a cold and salty substance is able to reduce and purge the Fire and protect the Yin of the body. These substances are effective for treating disorders with obvious Heat signs. The commonly used substances are Mu Li, Ci Shi, Zhen Zhu, Zhen Zhu Mu and Bai Zi Ren ( Platycladi semen).
Sweet
Sweetness has a capacity of moderating, tonifying and moistening. Some substances that are used for acute and severe cases are sweet in taste too. They can moderate the conflict and reduce the speed of the pathological progress of the disorder; Zhen Zhu and Zhen Zhu Mu are examples.
In chronic or mild cases, the sweet herbs are often used to tonify the Blood of the Heart and Liver, and moisten the Dryness that is caused by Yin and Blood deficiency. The commonly used herbs are Suan Zao Ren ( Ziziphi spinosae semen), Bai Zi Ren, He Huan Pi ( Albiziae cortex) and Ye Jiao Teng ( Polygoni multiflori caulis).
In clinical practice, one should be aware that the mineral substances control the symptoms of the disorder rather than treat the cause, so they should not be used for a prolonged period of time. When the condition of the patient has improved, the substances that treat the cause of the disorder should then be used.
Furthermore, mineral substances are heavy on the Stomach, and may cause indigestion, stomach pain and constipation; therefore they should be used together with other herbs that protect the Stomach. If the patient complains of such symptoms after taking these substances, or feels sleepy during the day, the dosage should be reduced, and may even need to be used only in the evening. In addition, the mineral substances have a descending tendency, so pregnant women should not use them, or use them with caution.
3. Ci Shi ( Magnetitum), Zhen Zhu ( Margarita usta), Zhen Zhu Mu ( Concha margaritifera usta) and Hu Po ( Succinum) are all used for disturbance of the Heart-Spirit. What are the differences between them?
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