Four years ago, I began providing acupuncture treatments to a retired Army Ranger who had been shot four times in Vietnam. As the treatments continued and his pain was relieved, we began to address other issues. I learned that the patient had been diagnosed by the VA with PTSD and met all DSM-5 criteria for PTSD. Acupuncture had not improved the patient's PTSD symptoms, so I began to think more about how to map PTSD into a TCM framework and about how it might be treated with herbs. I remembered two things:
One was an experience eight or nine years ago following a very upsetting interaction with a family member. That evening, I took a commercial Chinese herbal sleep formula. Normally, the incident would have been on my mind for several weeks, but the next morning I felt calm and centered. I could clearly remember all that was said, but there was little emotion attached to it. Today, I cannot recall the subject of the altercation, but have remembered that formula and its effect.
The second was a conversation about PTSD with a professor during an internship at the Canandaigua, N.Y., VA hospital. He explained that a sudden, violent event can cause a person's qi to be scattered. Often this scattered qi naturally coalesces as the person recovers, but sometimes the qi remains scattered and the heart / shen is disturbed.1
In this situation, the person relies on willpower (kidney / zhi) to cope with everyday life and struggles with PTSD symptoms such as dream-disturbed sleep, anxiety, fear, aggression, flashbacks, and intrusive thoughts and memories.
The Power of Chinese Herbs
Certain combinations of Chinese herbs have the ability to gather and coalesce the scattered qi, settling and anchoring it back into its normal circulation to restore equilibrium. Chinese herbs can quickly and effectively consolidate qi (3-5 g of granules on two consecutive nights), even after decades of suffering. The following Chinese herbal formula has been successful in treating PTSD in both civilians and veterans. (See Table 1)
Herb | Grams | Channels | Function in this Formula |
| Suan Zao Ren / Ziziphus spinosa | 30 | HT, LR SP, GB | Nourishes heart yin and blood, quiets the spirit, gathers qi |
| Bai Zi Ren / Arborvitae seed | 16 | HT, KD, LI | Nourishes the heart, calms the spirit, gathers qi |
| Zhen Zhu Mu / mother of pearl | 15 | HT, LR | Sedates fright, calms the spirit, anchors yang |
| He Huan Pi / mimosa bark | 9 | HT, LR | Calms the spirit and relieves constraint |
| Chuan Xiong / Ligustum cnidium | 9 | LR, GB, P, SJ | Harmonizes blood, relieves headache |
| Ye Jiao Teng / Caulis spatholobi | 9 | HT, LR | Nourishes blood, calms spirit, unblocks channels |
| Fu Shen / Sclerotium poriae | 6 | HT, SP, LU, KD | Calms the heart |
| Gan Cao / licorice root | 6 | All 12 | Harmonizes herbs, nourishes blood and qi |
Gathering Qi Herbal Formula
The dui yao of suan zao ren and bai zi ren constitute the chief herbs in the formula. They have a much greater effect on consolidating qi than either herb alone.2-3
One of the heavy sedative herbs, zhen zhu mu in this case, is necessary to anchor the collected qi so the effects of the formula will be long-lasting.
He huan pi enters the heart and liver, and is important because it relieves some of the constraint that has been imposed by the kidney/ zhi in its attempt to "keep everything together."
Comparison of Formulae
This granular formula is related to the sedative formulas that calm the spirit,4 such as Tian Wang Bu Xin Dan, Zhen Zhu Mu Wan, and the commercial sleep formula I took eight years ago. Some of these formulae are widely used as sleep aids and are very safe (assuming you avoid traditional formulas with toxic heavy metals such as cinnabar / zhu sha.) (See Table 2)
Function | Tian Wang Bu Xin Dan | Zhen Zhu Mu Wan | Sleep Formula | Gathering Qi Formula | |
| Suan Zao Ren | Gather qi/ calm shen | 9% | 11% | 30% | 30% |
| Bai Zi Ren | Gather qi/ calm shen | 9% | 11% | 15% | 16% |
| Fu Shen/ Fu Ling | Calm shen | 5% Fu Ling | 6% Fu Shen | 6% Fu Ling | 6% Fu Shen |
| Zhen Zhu Mu | Anchor qi | None | 9% | 10% | 15% |
| Long Chi | Anchor qi | None | 6% | None | None |
| Total Herbs in Formula | 13 | 10; omitrhino horn | 10 | 8 | |
| Gathers and anchors qi? | No. Relies heavily on nourishing blood. | Not tested. May need more suan zao ren. | yes | yes |
The Case Study
A 69-year-old male, retired Army Ranger, shot four times in Vietnam, was being treated with acupuncture for chronic pain from his war injuries and from more recent surgeries. He took the Gathering Qi formula, 5 g of granules at bedtime, on two consecutive nights in February 2020. He requested a second dose for two nights a month later. Some of the changes in his mood and emotions are summarized in Table 3.
PTSD Symptoms | Before Taking Herbs | 10 mo. After Taking Herbs |
| Unwanted upsetting memories | Daily | None |
| Flashbacks | Two out of three days | Seems very distant |
| Emotional distress after exposure to traumatic reminders | Children, helicopters | Seems distant and surreal |
| Overly negative thoughts and assumptions about oneself or the world | Always know the evil men do; feel that things are my fault | Somehow seem to be at peace with things |
| Irritability or aggression | Guard myself | No feeling of aggression |
| Difficulty concentrating | Yes | Much better |
| Difficulty sleeping | Yes | Sleep better |
| Other symptoms? | Sadness, guilt, no hope | Calm, happy maybe |
| How long have symptoms lasted? | 1970 to 2020 | They seem far away, like I'd need binoculars to see them |
The patient in this case study was taking no narcotic pain relievers, no psychotropic drugs (prescription or otherwise) and does not drink. The presence of drugs or alcohol may interfere with the efficacy of the Gathering Qi formula.
You will find that not everyone diagnosed with PTSD has scattered qi. If the patient does not, they will only experience a better night's sleep with this herbal formula. If they do have scattered qi, the results can be dramatic.
Hopefully this example will encourage other practitioners to, in the spirit of Shen Nong, combine their learning and their own experiences with herbs to find additional ways to help their patients.
References
Chronic pain afflicts over 20% of the adult population. Sadly, most MDs have essentially no education in treating pain, beyond offering a few toxic medications. Then they tend to steer people with pain away from those health practitioners who are trained. This puts the acupuncture community on the front lines for addressing this epidemic.
When the body is going through a stressful event, the sympathetic system is activated. This activation will help the body with a life-threatening situation. If this state is activated for prolonged periods of time, it starts to consume energy. These traumatic events that generate stressors in the autonomic nervous system (ANS) will eventually become internalized.
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One of the things that makes acupuncture so difficult to measure is that the medicine actually does contain some esoteric aspects. There have been numerous studies that demonstrate the neurochemical reasoning behind why acupuncture points stimulate the autonomic nervous system to enact change However, not all the benefits of TCM can easily be measured by randomized, controlled trials. But does that make them fundamentally and definitively untrue?
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