Key Diagnostic Points:

• There is a history of mental conflict, or a long period of mental stress.
• Reduced cerebral function manifesting in such symptoms as insomnia, dream disturbed sleep, waking up too easily, poor memory, inability to concentrate, listlessness.
• Mood swings accompanied with restlessness, hypersensitivity, low tolerance to sound and light.
• Functional disorders of the viscera such as palpitation, abdominal distention, belching, anorexia, constipation, frequent urination, impotence.
• Diseases of the (Western) internal organs should first be ruled out before diagnosing neurosis. Sometimes, Shen problems come from the internal viscera and are not related to neurosis. i.e. Brain tumors or Uremia.

Differential Diagnosis:

1. Stagnation of the Liver Qi: Difficulty in falling asleep, restless sleep, unpleasant dreams, emotional depression, excessive doubting, Anxiety, pain and distention of the head, feelings of oppression in the chest, hypochondriac pain, fullness in the abdomen, eructation, anorexia.

Tongue: Red with white coat
Pulse: Wiry

2. Heart and Kidney failing to communicate: (Kidney Yin Xu and Heart Fire) Anxiety, insomnia, dizziness, tinnitis, palpitation, five center heat, weakness of the loins and knees, dry mouth with little saliva, amnesia.

Tongue: Red with yellow coat or possibly very little coating
Pulse: Thready and rapid

3. Deficiency of Heart and Spleen Dream disturbed sleep and difficulty in falling asleep, easily awakened, palpitations, poor memory, fatigue, and general weakness. Sallow complexion, anorexia.

Tongue: Pale body with thin white coat
Pulse: Thin and weak

4. Phlegm heat harassing the mind. Restless sleep, tossing and turning, unpleasant dreams, a feelings of heaviness in the head, dizziness, a feeling of oppression in the chest, nausea, anorexia, palpitations, mental restlessness, sticky sensation in mouth.

5. Heart and GB Qi Xu Waking up very early in the morning with the inability to fall back to sleep, awakened easily regardless of hour, dreaming a lot, propensity to be easily startled, timidity, lack of initiative and assertiveness, palpitations, breathlessness, tiredness.

Tongue: Pale
Pulse: Wiry, thready

Treatment Principle:

Calm Shen, soothe heart

Point and Technique Prescription:

Du 24 Spirit Palace
GB 13 Root Spirit (bilateral)
Si Shen Cong ("Four Intelligent Shen")
All seven of these points are located on the head and are points with the word "Shen" in them. The brain is the palace of the original Shen and these points serve to calm the Shen.

Ht 7 Yuan source of Heart channel
PC 7 Yuan source of Pericardium channel
PC 6 Luo connecting point of the Pericardium channel
The three points are selected because of the Heart's (and pericardium's) effect on the Shen, the Heart controls the Shen.

An Mian (extra point) "Tranquilizing Sleep". This point is found at the midpoint of the line connecting GB 20 and Yi Ming. Yi Ming is found half way between GB 20 and San Jiao 17. So, An Mian is found one quarter of the way from GB 20 to SJ 17.

Sp 6 The crossing point of the Kidney, Liver, and Spleen channels. If the Yang Qi can retreat into the Yin, then a person can fall asleep. Tonifying Yin allows for this. Neurosis is not only concerned with Heart, Pericardium and G.B., but is also with Kidney, Spleen and Liver.

1. For Liver Qi Stagnation, add-

Liver 3 Yuan source point of the Liver channel
UB 18 Liver shu
UB 47 "Hun men" or the door to the ethereal soul.
Ren 17 Sea of Qi
These four points regulate Liver Qi, calm Shen.

GB 44 for dream-disturbed sleep. This point is called "Foot Portal Yin" which is the portal through which Yang can enter Yin for sleep to occur.

2. For the Heart and the Kidney not communicating (Kid Yin Xu and Heart Fire), add-

Kid 3 Nourishes Kidney Yin
Kid 6 Nourishes Kidney Yin.
Kidney 6 is the confluent point of the Yin-Qiao channel as well as its beginning point. Kidney water serves as the source (i.e. "Sea") for the Yin Qiao channel. Yin Qiao Mai not only controls the Yin, but also controls the opening and closing of the eyelids. In the case of either Yang excess, or Yin Xu, Yang Qi cannot retreat into the Yin at night, leading to insomnia. Hence, the eyes stay open all night. When you tonify Kidney 6, it tonifies the Yin Qiao meridian's ability to close the eyes. The eyes opening and shutting, is a question of balance between Yin Qiao and Yang Qiao.

Heart 8
PC 8
Both of these points are the Ying spring points, used for Heart fire.

UB 15 Heart Shu
UB 23 Kidney Shu
These two points used together to harmonize Heart and Kidney.

UB 44 Hall of the Shen
UB 52 Room of the Will Power
Again, more harmonization of Heart and Kidney, this time, on a psycho-spiritual level.

3. For Deficiency of Heart and Spleen, add-

UB 15 Heart shu, tonifies heart, calms Shen.
UB 20 Spleen shu, nourishes Spleen
St 36 Nourishes Spleen

4. For Phlegm heat harassing the mind, add-

St 25, Ren 12, Ren 6, St 40
The Four doors, and Stomach 40 are to resolve the phlegm

Sp 9
Resolves dampness, which helps to resolve the phlegm.

L.I. 11 He sea point of the L.I. channel
Clears Heat.

St 8 Local point for phlegm in the head. It also promotes sleep.

St 44 Ying spring point
Clears heat in the stomach, calms Shen and promotes sleep. This point is specific for excessive and unpleasant dreaming.

5. For Heart and GB Qi Xu

UB 15 Heart shu
UB 19 GB shu
These two points are for tonification of the Heart and G.B.

GB 40 Yuan source point
GB 34 He sea point
Tonifies GB Qi.

More from Dr. Ma at: Acuherbsonline.com