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Introduction: I desire study, work, and life; I also desire rest, but I cannot have both. How can one alleviate dizziness and insomnia caused by excessive mental exertion at work?

Self-formulated Liver-Nourishing and Wind-Extinguishing Decoction

Yang Yingjie

I am seeking effective prescriptions. In my practice, I frequently encounter patients who are typically intellectuals and mental laborers. Due to the demands of study and work, they often overuse their brains and lack sufficient sleep, leading to impairment of Yin fluids and resulting in symptoms of insufficient liver Yin such as dizziness and insomnia. Therefore, I often use my self-designed Nourish Liver and Extinguish Wind Decoction in clinical practice, with quite favorable results.

I hereby transcribe the original prescription and the significance of its composition for reference in treating such conditions.

Composition:

Chrysanthemum 15g, Gambir Plant 15g, Prepared Polygonum Multiflorum 15g, Tribulus Terrestris 15g, Glossy Privet Fruit 15g, Eclipta Prostrata 15g, Red Sage Root 15g, Achyranthes Bidentata 10g, White Peony Root 15g, Prepared Licorice Root 6g.

Function:

Nourish the liver, cultivate yin, and extinguish wind.

Indications:

Dizziness with a heavy head, vertigo, difficulty sleeping, weakness in the lower limbs, and a wiry pulse.

Formula Analysis:

Both chrysanthemum and gambir vine possess a sweet, bitter, and slightly cold nature and flavor. They can calm the liver and brighten the eyes, treating dizziness and blurry vision. They are commonly used for calming the liver and extinguishing wind. Therefore, chrysanthemum is used as the primary herb, combined with gambir vine to enhance its effect.

Since stirring of liver wind always stems from damage to liver and kidney yin, prepared fleeceflower root, flatstem milkvetch seed, glossy privet fruit, and eclipta are also used to nourish and tonify the liver and kidneys. These herbs address the root cause by tonifying while clearing heat, serving as auxiliary herbs in the formula. Fleeceflower root has a sweet and bitter flavor, tonifying the liver and kidneys, astringing essence and qi, nourishing blood, and dispelling wind. Using the prepared form avoids lubricating the stool. Flatstem milkvetch seed is produced in Tongguan and also in the old Tongzhou region of Shaanxi, also known as "Sijili." It also has the function of tonifying the liver and kidneys, brightening the eyes, and benefiting essence. Although its nature and flavor are sweet and warm, it is actually a mild tonic. Both glossy privet fruit and eclipta are sweet, neutral, and slightly cold. They can benefit the liver and tonify the kidneys, while also clearing internal heat caused by yin damage. Their inclusion among the auxiliary herbs embodies the principle of treating the disease by addressing its root.

Salvia miltiorrhiza combines the functions of four substances, excelling more in promoting blood circulation than in tonifying blood. When used with tonifying herbs, it acts to promote movement without injuring the healthy qi, to tonify without causing stagnation, and to treat wind by first treating blood. Achyranthes bidentata from the Huai River basin, being long, large, and thick, is better than that from Sichuan. It primarily guides the upward-rebellious heat downward and, when used with Paeonia lactiflora, which pacifies the liver, nourishes blood, and restrains yin with its bitter, sour, and slightly cold nature and flavor, enhances the effect of suppressing ascendant hyperactivity of liver yang, serving as an adjuvant and messenger in the formula.

Glycyrrhiza uralensis, sweet and neutral, not only harmonizes various herbs to bring out their strengths but also tonifies the center, embodying the principle of treating the liver by regulating the spleen.

According to the formula's principles, this prescription is effective in treating syndromes caused by liver yin deficiency and ascendant hyperactivity of liver yang.

[Note]

There are various causes of dizziness and vertigo, but liver-kidney yin deficiency with internal wind ascending to disturb the head (including hypertension and neurasthenia) is relatively common. Traditional Chinese medicine has accumulated rich theoretical knowledge and diagnostic and therapeutic experience regarding the etiology, pathogenesis, and treatment principles of this condition through long-term observation and exploration. Under the theoretical guidance of "all dizziness and vertigo are attributed to wind, and all wind-induced trembling and dizziness are related to the liver" from *The Yellow Emperor's Inner Classic: Plain Questions • The Great Treatise on Ultimate Truth*, treating this condition by nourishing the liver and extinguishing wind aligns with the classical principles.

Regarding treatment methods, various insights proposed by renowned physicians of the Qing Dynasty, such as draining wood to calm the stomach, suppressing yang to extinguish wind, transforming wind with pungent and sweet herbs, and nourishing blood to soften the liver, hold practical and reference value. Through study and personal insights, as well as analysis and summarization, it has been determined that "nourishing the liver and extinguishing wind" is the treatment principle and formula name for this condition.

Since this condition is a chronic ailment and requires prolonged administration to take effect, mild herbs with balanced properties that are neither excessively cold nor overly drying are selected for the formulation to avoid imbalance. Therefore, the clinical application of this approach has proven to be highly effective.

Furthermore, excessive mental exertion, staying up late at night, emotional tension, and psychological stress can lead to overfatigue of the cerebral cortex, all of which can easily trigger the onset of this condition. Therefore, during the course of medication, it is essential to maintain physical and mental calmness, adopt an optimistic attitude toward challenges, and engage in appropriate light physical activities such as qigong, tai chi, or disco dancing. Establishing a regular daily routine and practicing dietary moderation are also crucial. It is important to strictly control the consumption of rich and greasy foods, tobacco, alcohol, and spicy and heat-inducing items such as chili peppers, pepper, ginger, and fried foods. By closely coordinating with treatment, the therapeutic outcomes can be significantly enhanced.