Xu Rongzhai's Experience Treating Women's "Zang Zao" (Hysteria or Bipolar Disorder)
The disease of "zang zao" has been recorded as early as the time of Zhang Zhongjing. Zhang Zhongjing's Gan Mai Dazao Decoction (Licorice, Wheat and Jujube Decoction, composed of wheat, jujube and licorice) can be regarded as the ancestral TCM formula for treating zang zao; later formulas such as Dan Zhuru Decoction were derived from Gan Mai Dazao Decoction. Since those who suffer from "zang zao" are mostly women, this disease gradually came to be classified as a gynecological miscellaneous disorder.
As a master of gynecology, Xu Rongzhai also treated some patients with "zang zao." Xu Rongzhai believed that zang zao is mostly due to depletion of the yin fluids of the heart and liver, giving rise to mental symptoms such as vexation and restlessness, depressive temperament, suspiciousness and proneness to anger; this disease is classified in modern medicine as a mental disorder.
The onset of zang zao is intermittent. During an attack the patient feels agitated and irritable, sighs for no reason, is pessimistic and world-weary, grieves to the point of weeping, and is sensitive and irritable; severe cases may even show somatization symptoms such as spasms of the limbs, headache and abdominal pain. Such symptoms are recorded in many ancient Chinese medical texts. Some contemporary TCM physicians consider it to be hysteria in modern psychiatry, while others regard it as depression or bipolar disorder; in terms of symptoms, zang zao also resembles borderline personality disorder.
In fact, it is still difficult to correspond TCM zang zao to a specific disease name in psychiatry; one can only attempt symptomatic treatment with the corresponding formulas.
The most common method Old physician Xu Rongzhai used to treat such patients was to combine Gan Mai Dazao Decoction with Xiaoyao Powder (Free and Easy Wanderer Powder).
If the patient is dizzy, add Haliotidis Concha (Shijueming) and Tribuli Fructus (Baijili); if the patient has chest stuffiness, add Perillae Caulis (Sugeng), Albiziae Cortex (Hehuanpi) and Acori Tatarinowii Rhizoma (Shichangpu); for insomnia add Poria (Fuling), Polygoni Multiflori Caulis (Yejiaoteng) and Ziziphi Spinosae Semen (Suanzaoren); for palpitations add Fluoritum (Zishiying), Magnetitum (Cishi) and Ossis Mastodi Fossilia (Longgu); for constipation add raw Polygoni Multiflori Radix (Sheng Shouwu), Leptopus Rhizoma (Shanhailuo) and Platycladi Semen (Bairen); for excessive phlegm add Pinelliae Rhizoma (Banxia), Citri Reticulatae Pericarpium (Chenpi) and Baijin Pills; for weak and frail patients add Heche Dazao Pills.
Mr. Xu had rich clinical experience in gynecology; according to his records, the above treatments were mostly reliable in efficacy and should not be idle boasts. But the disease of zang zao is difficult to cure permanently. More women than men suffer from this disease, which may also be related to the X chromosome; women's genetic makeup and social roles make them more prone to anxiety and depression. In treating such patients, beyond medicine, family members need to offer more understanding and patience to help the patient release their emotions.