Mental Illness



Mental Illness was traditionally classed as Insanity, Madness, Mania, Melancholy, etc. Since ancient times, Evil Spirits, Ghosts, Demons and Witchcraft were often blamed for Mental Illness, and this belief still holds firm in many traditional cultures today.

Traditional texts and names of formula often use terms such as “Madness” which would be viewed as inappropriate today. However, this had no intended derogatory implications at the time of writing.

Traditional Classifications of Mental Illness
  • Frenzy–loss of understanding; comes with Fever; associated with Inflammation or swelling of the Brain. There is restlessness, talkative, dry and black tongue, forgetful, crying out in their sleep. If there is a red tongue with yellow coating and Fever, it is a classical Frenzy. There was said to be many kinds, but can generally be divided into three:
    • Blood–“they may adjudge all things as they be, know what it is; but how to think of it and use It do they know nothing at all”. Bloodletting is especially indicated.
    • Bile–”they do know in their thoughts or forecast nothing at all: but adjudge much otherwise of all that ever they see then it is”. Purging and Cooling enemas is especially indicated.
    • Melancholy–”they be so distracted of their wits, that they can neither discern right, nor adjudge right”
  • Mania or Madness–altered understanding with raging and madness, but without Fever. “
    alterations In words or deeds done without sense or reason, like as much talk and prating, much Waking, leaping; great troubles, and such like” (Wirtzung) This was commonly believed to be Possession in ancient times..
  • Melancholy–”corruption of the judgement and thoughts. altered from their natural kind, into an unnatural and spoiled manner, tempered with fear and care [worry]” (Wirtzung)
  • Hysteria–occurs in women, often likened to Epilepsy. Said to be caused through retention of menstruation or “retention of the natural seed, especially to them that be accustomed to have the company of a man, and must then forbear it, as widows, and aged maidens” (Wirtzung). Symptoms include dizziness, headache, madness, shortness of breath, palpitations, sometimes with redness of the face and eyes, gnashing of teeth. However, they retain their Memory and Knowledge. This is dealt with under PMS & Hysteria.

Humoral Differentiation
The Western Humoral system classifies most mental illness as being associated with Melancholy humor. However, some cases are caused of Heat, being like the classification of Mania in TCM: a Hot or Yang disorder. The other type is more Damp or Phlegm which is similar to the Yin-Withdrawal patho-mechanism of TCM. It can also be classified according to the Humors:
  • Blood: sings, merry, thinks they are in heaven, or an Angel or God talks to him, or believes himself to be rich, or a King etc. Maybe over joyous or maniacal. They have a rosey face and a full pulse.
  • Congealed or Burnt Blood: maybe a little Merry, then gets angry, cries, beats themselves etc. Dull complexion, cyanosis, choppy pulse.
  • Melancholy: Gloomy, sad, fearful (without cause), may see inanimate objects such as serpents or venomous beats, sits in the dark alone, hands clasped together; crows like a rooster or barks like a dog etc. Also maybe cruel or suicidal. The have a thin frame, dull complexion, small pulse and a scared look in their eyes.
  • Phlegm: mind is heavy and dull, withdrawn, introverted. Their face is pale, excess phlegm, pale or flabby tongue with a white coating, and a slow pulse.
For with purging Black Cholera, is the Spleen cleansed, and therewith
avoids the strange thoughts and imaginations, the pensiveness and
Melancholy is driven out, and the Brains get again their force or strength,
and are increased
. Wherefore if this be done, then is the evil Spirit or
Will driven out, and all wicked thoughts are forgotten
.’ (Brunschwig, 1561)

TCM Differentiation
TCM divides mental illness broadly into ‘Withdrawal’ and ‘Mania’. The first is Yin (Cold/Phlegm/Deficient) withdrawn into oneself; the second is Yang (Hot/ Excess), is extroverted, aggressive and outwardly expressive: talkative, dancing etc.

Older texts gave a number of causes: Bad Food, Excess drinking
, Dampness or undigested Humors in the Stomach, Infected Air, Anger or excess other emotions etc.

Traditional Psychotherapy
Various forms of Psychotherapy were recommended in Traditional texts. Surrounding the patient with pleasant sights, smells and sounds was long seen as beneficial. Keeping them occupied and encouraging them to partake in social activities. Those with sadness and heaviness of mind should be made joyful and told happy things. Brunschwig (1561) had other useful advice: “Many things should be promised him, and some given’. Also ‘If it is a man, the same ought to be refreshed with women, the same avoids Anger. But if it is a Woman, the same ought to be refreshed with men, and to their company admitted: the same brings them to their right Mind again’.

Diet was long recognised as important. Easy to digest foods such as Lamb, Chicken, Eggs, Bread and avoiding strong drinks or heavy foods. Avoid overeating, and allow food to digest once eaten, avoiding eating upon half digested food.

Treatment
A regular Purge in those with an excess type Mental Illness is beneficial. Pills of Cochia, Pills of Lapis Lazuli or Confectio Hamech are examples of those suitable as a purge. Restorative medicines that strengthen the Heart and calm the Mind and Nerves may be given in the interim.

Those with excess Blood or an excess condition can be Bled. If there is Frenzy with Fever, a red tongue with yellow coat, the Head vein was opened even until they feel weak, then 4 days later the vein of the Forehead. Another version suggested opening the Forehead vein, then 6 days later the the vein between the Thumb and Forefinger. In Unani, Cupping with Bloodletting (Hijama) on the head (the head being shaved) is highly regarded.

Various scents have long been used in such cases. The fumes of equal parts of Frankincense and St. Johns wort were claimed to repel Evil Spirits and Witchcraft. They appear to have given relief to those affected with mental illness. Likewise in the East, Sandalwood is said to have a positive effect in lifting the vibration of areas such as temples, and is beneficial to the frantic and those with insanity.

Certain medicines can also be worn to promote a positive effect. These include Pearl, Coral, Amber, various precious stones, Gold etc.

Western Tradition

Simples
Borage
St. John’s wort
Dodder
Agaric
Black Hellebore prepared

Bugloss
Scarlet Pimpernel
Fumitory
Polypody
Lapis Lazuli prepared
1. St. John’s wort: long used for ‘Melancholy, Troubled Mind and Foolish Imaginations’.
2. Scarlet Pimpernel:
i. Madness: ‘The Decoction of Pimpernel with a Purple Flower is famous’. (London Practice of Physic, Dr. Willis, 1689)
ii. Mania: ‘After vomiting, for certain days let him take the Decoction of Anagallis that bears a purple flower, without any addition. Wine must by no means be given’. (Practical Chymistry, John Hartman, 1670)
3. Mistletoe: ‘It is good for any kind of disease of the brain, nerves, and back, Epilepsia, Mania, or Mental infirmity of any kind, Paralysis, all weakness of joints, sight, hearing, or senses’. (The Physicians of Myddvai, translated by John Pughe esq., 1861)

Madness, Mania, Mental Illness
Conserve of Borage
Conserve of Bugloss

Cordial Decoction (French Pharmacopoeia)
Syrup of Apple of the King of Sapor
Tincture of St. John’s wort
Tincture of Black Hellebore
Powder of Crabs 
Powder for Madness (Rondeletius)
Powder for Madness (2) (Rondeletius)
Powder for Mixed Humors (Mesue)
Troches of Rose (Mesue)
Antidote Proven for Diverse Diseases
Arabian Confect Purging Melancholy (Confectio Hamech)
Electuary for Melancholy

Hiera Logadii
Electuary of Senna (Diasenna) (Nicholas)
Electuary of Dodder
Triphala Electuary of Dodder (Unani)
Triphala Electuary to Purge Phlegm and Black Bile
Pills of Azurite (Mesue)
Pills of Dodder
Pills of Lapis Lazuli 1 (Mesue)
Safoof e Jawahar Mohra (Precious Defender Powder)

Aloeswood 20 (A gar nyi shu) (Tibetan)
Eleven Holders of Life (Srog dzin bcu gcig)
Mental Happiness (Sems kyi bde skyid) (Tibetan)
Sarasvata Churna (Ayurveda)
Sarpagandha Ghana Vati (Ayurveda)
Vajra conquering Heart Wind 17 (Tibetan)


Mania and Mental Illness with Heat
Cordial Decoction (French Pharmacopoeia)
Troches of Rose
Life Holding Jewel (Srog ‘dzin nor bu) (Tibetan)
Safoof e Jawahar Mohra (Precious Defender Powder)


Mental Illness from Wind 
Safoof e Jawahar Mohra (Precious Defender Powder)
Aloeswood 20 (A gar nyi shu) (Tibetan)
Eleven Holders of Life (Srog dzin bcu gcig) (Tibetan)
Life Holding Jewel (Srog ‘dzin nor bu) (Tibetan)
Mental Happiness (Sems kyi bde skyid) (Tibetan)
Vajra conquering Heart Wind 17 (Tibetan)


Mental Illness from Melancholy
Cordial Decoction (French Pharmacopoeia)
Triphala Electuary of Dodder (Unani)
Triphera of Dodder of Thyme (Mesue)
Triphala Electuary to Purge Phlegm and Black Bile
Arabian Confect Purging Melancholy (Confectio Hamech)
Pills of Azurite (Mesue)
Pills of Lapis Lazuli 1 (Mesue)
Pills of Dodder
Hiera Logadii
Safoof e Jawahar Mohra (Precious Defender Powder)

Dawa-ush-Shifa (Rauwolfia & Black Pepper) (Unani)
Triphala of Zamani (Itrafil Zamani) (Unani)
Confection of Silk Coccoon (Khamira Abresham) (Unani)



Mania & melancholiam purgant –
Purge Mania and Melancholy

Arabian Confect Purging Melancholy

Electuary of Senna (Diasenna) (Nicholas)
Hiera Logadii
Hiera Pachius
Pills of Azurite (Mesue)
Pills of Lapis Lazuli 1 (Mesue)


Mania and Mental Illness associated with Menstruation–’Uterine Fury’
Syrup of Agnus Castus


Insanity, Psychosis
Arabian Confect Purging Melancholy (Confectio Hamech)
Pills of Azurite (Mesue)
Pills of Lapis Lazuli 1 (Mesue)
Pills of Dodder
Safoof e Jawahar Mohra (Precious Defender Powder)
Aloeswood 9 (A gar dgu pa) (Tibetan)
Aloeswood 20 (A gar nyi shu) (Tibetan)
Mental Happiness (Sems kyi bde skyid) (Tibetan)
Nux Vomica 15 (Ko byi bcu lnga) (Tibetan)
Sarasvata Churna (Ayurveda)
Sarpagandha Ghana Vati (Ayurveda)


Dumbness, Stupidity
Confection of Galen
Aloeswood 20 (A gar nyi shu) (Tibetan)
Mental Happiness (Sems kyi bde skyid) (Tibetan)


Mental Illness with Fear and Depression
Pills of Azurite (Mesue)
Pills of Lapis Lazuli 1 (Mesue)
Aloeswood 10 (A gar bcu pa) 
Mental Happiness (Sems kyi bde skyid) (Tibetan)
Yak Blood 8 (‘Brong rtse ar brgyad)


To Purge in Mania
Arabian Confect Purging Melancholy (Confectio Hamech)
Electuary of Senna (Diasenna) (Nicholas)
Hiera Logadii
Indian Pills (Mesue)
Pills of Azurite (Mesue)
Pills of Lapis Lazuli 1 (Mesue)



To Strengthen after
Powder of Three Sandalwood (Ditrionsantalum)
Abbots Confection of Roses (Diarrhodon Abbatis)
Cooling Pearl Powder (Diamargariton Frigidum)
Cooling Powder of Gems (Species de Gemmis Frigidii)
Electuary of Gems (Mesue)
TCM Classification

Withdrawal

Phlegm and Qi Stagnation
pensiveness, sadness, excessive thinking and worry, inability to concentrate, listless, blank expression, moodiness, poor appetite.
Xiang Sha Liu Jun Zi Tang
An Shen Ding Zhi Wan
Bai Jin Wan
Shun Qi Dao Tan Tang
Wen Dan Tang
Gun Tan Wan

Zhi Bao Dan


Heart and Spleen Deficiency
doesn’t think clearly, strange dreams, fear, easily frightened, worrying too much, emotional, crying, poor appetite, low energy, lethargy.
Gui Pi Tang
An Shen Ding Zhi Wan
Gan Mai Da Zao Tang
Yang Xin Tang


Mania

Heat Annoying the Spirit
Acute Mania, fever, constipation, dry mouth, dry and cracked tongue with yellow, dirty or black tongue coating
Da Cheng Qi Tang
Zhu Sha An Shen Wan


Cordial Decoction (F.P.)
Troches of Rose (Mesue)
Phlegm Heat / Fire
severe restlessness, lack of rational thinking, anger, red eyes, red face, no appetite, insomnia, loss of recognition of people, aggressive, very strong, red tongue with yellow or dirty coating, big and fast pulse.
Dang Gui Long Hui Wan
An Gong Niu Huang Wan
Gun Tan Wan
Ci Zhu Wan


Yin Deficient Heat / Fire damages Yin
chronic mania, may have improved, fatigue, no energy, easily frightened, restlessness, thin body, red face, red tongue.
Ding Zhi Wan
Tian Wan Bu Xin Wan



Blood Stagnation
Mania, Schizophrenia with irritability, restlessness, Fixed pain, dull complexion, cyanotic lips, tongue and fingernails, choppy pulse
Tao He Cheng Qi Tang
Di Dang Tang


Wind

Ayurveda and Tibetan Medicine recognises Wind as being a cause of some Mental disease. Particularly, ‘Heart Wind’ and ‘Wind of the Life Channel’ contain some interesting formulas for Mental Instability and Mental Disease.

Heart Wind
Wind in the upper body affects the Heart, Mind and Spirit. There will be chest pain and oppression, poor memory and concentration, nervousness, fatigue, mental instability, shortness of breath, insanity
Bi Ma La (Tibetan Medicine)
Eleven Holders of Life (Srog dzin dcu gcig) (Tibetan)
Vajra conquering Heart Wind 17 (Tibetan)


Wind affecting the Life Channel
Pain and oppression in the upper back, stress, anxiety, thinking too much, poor concentration, possibly leading to Insanity which is manic and changeable.
Mental Happiness (Sems kyi bde skyid) (Tibetan)
Vajra conquering Heart Wind 17 (Tibetan)


Special Formula

ACUTE INSANITY
1. Digitalis Tincture every 3 hours.
2. “Acute Insanity (with intense congestion of head, face, hands and feet).Cured with Fluid Extract of Ustilago, adult, I drachm, every 6 hours.” (The medical genius – a guide to the cure, Jones, 1887)

A DRINK FOR INSANITY
i. Lapis Lazuli infused in Aqua Vitae
ii.  Aqua Vitae                   2 tablespoonfuls
    Wine                             6 tablespoonfuls
    Senna powder            2 drams
Mix and give every morning. (Brunschwig, 1561)

FRENZY
Lily of the Valley flowers, steeped 2 weeks in old wine, then distilled in a water bath was “much commended above all things” (Wirtzung)

‘THE HEREDITARY SPECIFIC OF SENNERTUS FOR MADNESS’.
    Balm flowers (or leaf)  1 handful
    Powdered Pearls         ½ dram
    Brandy                           4 oz.
Chop the Balm small, then mix and make a Tincture, SA.
    A supposed specific for Madness. Dose: 2 spoonfuls as a dose. (Salmon, Synopsis Medicinae, 1695)

TRIPHERA OF DODDER OF THYME
    Myrobalans Chebula
      Emblic
      Belleric
      Black                           1 part each
    Dodder of Thyme       2 parts
    Hiera Picra                   ½ parts
Mix with Honey of Emblic or ChebulIc Myrobalans.
  For Mania and Melancholy. (De Morbis Internis Curandis, Mesue, 1551)

MADNESS FROM PHLEGM OR COLD
    Senna                           2 drams
    Sugar                           ½ oz.
    Aqua Vitae
    Bugloss Water           1 tablespoonful each
    Pea Broth                    equal to the rest
Mix and take each morning for 3 morning. On the third day give him 3 Pills of Cochia. (Brunschwig, 1561)

ANOTHER FOR MADNESS FROM COLD
    Saffron                         2 drams
    Cinnamon                   ½ oz.
    Aqua Vitae                  ½ oz.
Sew the Saffron and Cinnamon in a cloth and infuse them  in a pint of white wine. Give some morning and evening. Clove can also be added.
POWDER FOR MADNESS (1)
    Coriander                    2 drams
    Water Lily flower       3 drams
    Violet flower
    Rose flower                2 drams each
    Lettuce seed
    Poppy seed                1 dram each
    Red Coral                    1 ½ drams
    Red Sandalwood       2 scruples
Form powder. (Rondeletius)

POWDER FOR MADNESS (2)
    Violet flower
    Water Lily flower       1 oz. each
    Rose                            ½ oz.
    Camomile flower        
    White Poppy seed        
    Poppy capsule
    Mandrake root bark  2 drams each
    Aniseed
    Dill seed
    Granorum tinctorum 1 scruple each
Form powder. (Rondeletius)

COMPOUND TINCTURE OF ST. JOHN’S WORT
    St. John’s wort            20 grams
    Scarlet Pimpernel     10 grams
    Bugloss flowers
    Rosemary
    Rose                             5 grams each
    Cinnamon                    3 grams
    Saffron                          1 grams
Prepare a tincture.
    This is an abbreviated version used for ‘Madness, foolishness of Mind, Enchantments, Sorcery, Witchcraft and Melancholy’.
Dose: 1-2 oz. (Mynsichts)



See also


Black Bile & Melancholy

Treatment of Melancholy by Wirtzung

Research


1. The most common native medicinal plants used for psychiatric and neurological disorders in Urmia city, northwest of Iran
2. Popular Herbal and Natural Remedies Used in Psychiatry
3. A Review of Herbal Medicines for Psychiatric Disorders
4. Ayurvedic concepts related to psychotherapy – PMC – NCBI
5. CONCEPT OF MENTAL HEALTH IN AYURVEDA
6. Traditional Chinese medicine in psychiatric practice in Singapore