Despite the enormous interest in the western world in the application of Chinese medicine for mental and emotional disorders, there are few textbooks devoted specifically to this subject, especially ones based on sound clinical experience. This book was published in 1987 by unnamed "Authors" from Hangzhou and is a fairly thorough examination of schizophrenia from both a western and Chinese medical perspective. There is some satisfying material on the traditional understanding of mental disorders (principally dian-kuang) in Chinese medicine, with quotations and opinions from many doctors through the ages. For example Li Chan of the Ming dynasty is quoted as follows:
Mania patients are ferociously mad. In mild cases they act self-important and self-righteous, they like to sing and like to dance; in more serious cases [patients] throw off their clothes and run amok, climb walls and mount the roof. In even more serious cases [patients may] beat their head [against a wall] and scream, be negligent around fire and water, or can have inclinations to murder. This naturally results from inordinate exuberance of the heart fire, superabundance of yang qi, the spirit failing to keep to its abode, and phlegm-fire congestion and exuberance. The crux of treating mania is to descend phlegm and downbear fire.
Li Chan further said
When a patient sees, hears, speaks, and acts absurdly, it is said to be due to the activity of evil spirits. This is just qi and blood in extreme vacuity, the spirit and will in insufficiency, or else it is complicated by phlegm-fire obstructing and dominating, so that the spirit is confused and unsettled. It is not really the work of ghosts and demons.
The process of the formation of phlegm and its relationship to mania is poetically described by Zhang Cong Zheng of the Jin dynasty [When the liver] constantly plans, and the gallbladder s constantly indecisive, by being bent over without stretching, and holding anger that is not discharged, the heart blood grows dryer by the day. Spleen humor does not move, and phlegm then confounds the orifices of the heart, forming heart wind. Subsequent chapters discuss the symptomatology and clinical classification of schizophrenia, its diagnosis and differential diagnosis and its prevention. The chapter on prevention is mainly devoted to traditional Chinese approaches to moderating the emotions, with additional and valuable sections on the importance of treating insomnia and of promoting strong social and familial networks.
The treatment section emphasises acupuncture with some further suggestions for herbal medicine formulas. Point and herbal prescriptions are given for mania (kuang) and withdrawal (dian), as well as symptomatic prescriptions for auditory and visual hallucinations, excessive speech, insomnia etc. The authors place considerable emphasis on good needle technique, especially directing the qi and applying supplementing and draining manipulation as appropriate. There are several case histories, reports on the available research into the acupuncture treatment of schizophrenia, classical acupuncture prescriptions, traditional psychological therapy, electroacupuncture, ear acupuncture, scalp acupuncture etc.
To conclude, this is a useful book for any practitioner willing and able to take on the treatment of serious and difficult emotional disorders.
