"Jianwang Dan" (Forgetfulness Pill) for Treating Fright and Forgetfulness
In the Ming-dynasty medical work Ren Shu Bian Lan (Convenient Guides to Benevolent Practice), there is a formula called "Jianwang Dan" (Forgetfulness Pill) specifically for treating excessive susceptibility to fright and forgetfulness caused by heart-qi deficiency. Its composition is as follows: Yuan Zhi (Polygalae Radix, remove the heart) 1 liang (30 g), Shi Chang Pu (Acori Tatarinowii Rhizoma, remove hairs) 1 liang (30 g), Huang Lian (Coptidis Rhizoma, stir-fried with ginger) 5 qian (15 g), Dang Gui Shen (Angelicae Sinensis Radix, washed in wine) 2 liang (60 g), Gou Qi Zi (Lycii Fructus, from Ganzhou) 2 liang (60 g), Suan Zao Ren (Ziziphi Spinosae Semen, stir-fried) 1 liang (30 g), Mai Men Dong (Ophiopogonis Radix, remove the heart) 1 liang (30 g), Gan Ju Hua (Chrysanthemi Flos) 5 qian (15 g), Sheng Di Huang (Rehmanniae Radix) 5 qian (15 g), Ren Shen (Ginseng Radix) 5 qian (15 g).
Preparation: Grind the above herbs together into a powder, refine with honey into pills the size of a phoenix-tree seed, and coat with 3 qian (9 g) of Zhu Sha (Cinnabaris). After preparation, take 50 pills each time, twice daily, washed down with tea water. This formula supplements the heart and boosts intelligence. It is indicated for heart-qi deficiency with excessive susceptibility to fright and forgetfulness.
The conditions treated by this formula belong to the emotional disorders of traditional Chinese medicine. Symptoms of excessive fright and forgetfulness generally appear in patients who have suffered psychological trauma; such patients often have cerebral impairment. Patients with stress trauma syndrome, depression, borderline personality, and anxiety disorders may exhibit these symptoms.
Yuan Zhi (Polygala) is a commonly used calming herb in TCM. Its main actions are to quiet the heart and calm the spirit, resolve phlegm and open the orifices, and reduce swelling and dissipate nodules. It is commonly used for unease of heart-spirit, palpitations, insomnia, forgetfulness, epilepsy and mania caused by phlegm obstructing the heart orifices, clouded consciousness, cough with copious sputum, and also for boils and swellings and breast pain and swelling. Modern pharmacological research shows that this herb has hypnotic, anticonvulsant, learning- and memory-improving, expectorant, blood-pressure-lowering, antibacterial, antimutagenic, and uterine-stimulating effects. However, Yuan Zhi has some irritant effect on the stomach, and patients with gastritis and gastric ulcers should use it with caution.
Shi Chang Pu (Acorus) is a commonly used TCM herb for calming the spirit and opening the orifices. Its main actions are to resolve phlegm and open the orifices, transform dampness and harmonize the stomach, quiet the heart and benefit the will. It is indicated for unconsciousness from febrile disease, phlegm syncope, forgetfulness, insomnia, tinnitus, deafness, oral-froid dysentery, and rheumatic bi pain. Modern pharmacology shows Shi Chang Pu has good sedative, spirit-calming, anticonvulsant, and antiepileptic effects, and improves learning and memory in animals. TCM has a single-herb remedy using Shi Chang Pu specifically for epilepsy. Some modern clinical studies show this herb improves brain function, has a marked ameliorating effect on epilepsy and pulmonary encephalopathy, and can also treat dizziness.
Huang Lian (Coptis) is a commonly used heat-clearing herb in TCM. Its actions are to clear heat and dry dampness, drain fire and resolve toxin. Besides treating vomiting and diarrhea caused by damp-heat fullness, it also treats vexation and unconsciousness, irritability and insomnia, stomach-fire toothache, and mouth and tongue sores. Thus it is also a spirit-calming herb. Yuan Zhi and Shi Chang Pu are slightly warm and dry; pairing them with Huang Lian reduces their warm-dry side effects.
Dang Gui (Angelica) is the foremost blood-tonifying herb in TCM and also has a blood-activating action. Modern pharmacological research shows that Dang Gui not only dilates the coronary arteries, reduces myocardial oxygen consumption, improves myocardial function, lowers blood lipids, and counteracts atherosclerosis, but also improves neuronal metabolism, accelerates cerebral blood circulation, and repairs brain damage caused by ischemia and other causes.
Gou Qi Zi (Lycium) is a commonly used yin-tonifying herb in TCM. Its main actions are to nourish the kidney and supplement the liver, brighten the eyes, and moisten the lungs. It is commonly used for dizziness and vertigo, diminished vision, sore and weak lower back and knees, wasting-thirst (diabetes), and cough due to yin deficiency, all caused by liver-kidney yin deficiency. Modern pharmacology shows Lycium can promote and regulate immune function, promote hematopoiesis, and has antioxidant, anti-aging, anti-fatigue, anti-hypoxia, and anti-atherosclerotic effects, and has a root-securing and origin-strengthening action.
Suan Zao Ren (Ziziphus seed) is a commonly used spirit-calming herb in TCM. It nourishes the heart and calms the spirit, astringes sweat, and generates fluids. It is commonly used for unease of heart-spirit due to yin-blood deficiency, insomnia with many dreams, palpitations and severe pounding of the heart, spontaneous sweating, and night sweating. Modern pharmacology shows Suan Zao Ren has sedative, anticonvulsant, antiarrhythmic, anti-myocardial-ischemic, blood-pressure-lowering, lipid-lowering, anti-atherosclerotic, anti-hypoxic, and learning- and memory-improving effects. Suan Zao Ren has a biphasic effect on sleep: it improves sleep quality in those with poor sleep, and reduces sleep time in those with somnolence.
Mai Dong (Ophiopogon) is a yin-nourishing herb. It moistens the lungs and nourishes yin, benefits the stomach and generates fluids, clears heart fire and eliminates vexation, and moistens the intestines to unblock the bowels. It is commonly used for dry cough with sticky sputum due to lung dryness, consumptive cough and hemoptysis due to yin deficiency, dry mouth and thirst due to yin deficiency, internal-heat wasting-thirst, irritability and insomnia, and constipation due to yin deficiency and intestinal dryness. Among yin-nourishing herbs, Mai Dong is notable for calming the spirit and eliminating vexation.
Ju Hua (Chrysanthemum) has the action of dispersing wind and clearing heat. It is a commonly used TCM herb for wind-heat colds, the early stage of warm diseases, wind-heat headache, liver-yang headache, vertigo, and heat-toxin sores and swellings. Modern pharmacology shows Chrysanthemum can improve coronary flow. Patients with palpitations and unease often have somatic symptoms such as headache; using Gan Ju Hua can also improve headache symptoms.
Sheng Di Huang (Raw Rehmannia) is also a heat-clearing and blood-cooling herb. It clears heat and cools the blood, eliminates vexation and stops bleeding, and moistens the intestines to unblock the bowels. It is commonly used for conditions such as reckless bleeding due to blood heat and irritability with constipation. Modern pharmacology shows Sheng Di Huang can inhibit the adrenergic-receptor excitation caused by large doses of thyroxine, and such adrenergic-receptor excitation is an important cause of palpitations and unease in some highly sensitive patients.
Ren Shen (Ginseng) is the most commonly used qi-tonifying herb in TCM. It strongly supplements original qi, supplements the spleen and boosts the lungs, generates fluids and stops thirst, and calms the spirit and improves intelligence; therefore it is also a spirit-calming herb. Modern pharmacological research shows that Ginseng can biphasically regulate cAMP and cGMP by improving the hypothalamic-pituitary-gonadal axis and influencing the function of endocrine glands such as the thyroid. Ginseng also has anti-fatigue and anti-aging effects.
Zhu Sha (Cinnabar) is mainly composed of mercuric sulfide and is toxic. It is a commonly used spirit-calming herb in TCM but is now mostly abandoned. The author does not recommend that modern patients coat their pills with Cinnabar when using this formula, because Cinnabar is toxic and its toxicity is considerable. Even without Cinnabar, this formula has good effects in tranquilizing fright, calming the spirit, and improving forgetfulness; there is no need to add Cinnabar.
In addition, depressed patients often have somatic symptoms such as headache. If the headache is marked, add Man Jing Zi (Viticis Fructus) 30 g, Bai Zhi (Angelicae Dahuricae Radix) 30 g, Ji Li (Tribuli Fructus) 30 g, and Chuan Xiong (Chuanxiong Rhizoma) 15 g to improve the headache. Such patients mostly have chronic illnesses and require long-term treatment; pills are recommended rather than decoctions.