Healthy body and happy spirit:

implication from traditional Chinese

healing art

Zhang-Jin Zhang (張樟進)

Professor, School of Chinese Medicine

The University of Hong Kong

November 11, 2020

Student suicide in Hong Kong

From September 2015 to October 2020,

there have been 160 students with under
19 years old who killed themselves in HK.
The youngest was only 10 years.

1
 針刺治療抗精神病藥物之遲發性運動障礙
Acupuncture for tardive dyskinesia (TD)

Acupuncture treatment of youth with OCD

針刺治療強迫症

2
 Herbal medicine
treatment of youth
with anxiety
中藥治療焦虑症

Acupuncture for tic disorder

3
 The prevalence of children and
adolescent psychiatric disorders in China

o Any: 9.5% o 對立品行障礙

o 焦慮症 (anxiety): 6.1%
o 創傷後應激障礙 (PTSD):
0.6%
o 強迫症 (OCD): 1.00%
o 抑鬱症 (depression):
1.32%
o 多動症 (ADHD): 0.84%
oppositional-conduct
disorder: 1.63%
o 抽動症 (tic disorders):
0.44%
o 進食障礙 (eating
disorders) : 0.54%
o 精神障礙 (psychotic
disorders): 0.5%

Xiaoli, et al., 2014

7

Depression a serious public health issue

抑鬱症已成為一個嚴重的公共健康問題

o Worldwide: 4.7% (Ferrari et al., 2013)

o China university students: 23.8%
(Lei et al., 2016)
p China outpatients: 27.0% (Wang
et al., 2017)
o Hong Kong: 5.23% (Chin et al., 2016)

抑鬱症已成為”情緒感冒”
Depression has been a “mood influenza”

4
 Contents

o Ancient concepts of body and

spirit
o TCM psychological and mental
illness
o Traditional Chinese healing arts
for mental health and wellbeing

A thousand-year argument:
The body and the spirit are separable
or inseparable?

o TCM philosophy: inseparability. The spirit is

born from the formation of the body, the
spirit exists in the existence of the body and
is gone with a dead body (形具而神生,形存而
神存,形謝而神滅)。
o Zhuangzi (莊子), an ancient eminent Taoist,
believes separability: The spirit is produced
from the Taoism, while the body comes
from inherited substances (精神生於道, 形本
生於精).

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 The spirit can influence the body?

o The spirit can drive the body (神

能禦其形).
o the body cannot survive without
the spirit (無神則形不可活)
o When the spirit is gone and
separated from the body, it is
called the death (神去離形謂之死).

What is health: WHO definition

o Health is a state of complete

physical, mental and social
well-being and not merely the
absence of disease or infirmity.
This Definition has not been
amended since 1948.

6
 What is health: TCM view
o The health of human being should be a
harmony of the body and the spirit (形與神
俱,形神合一). It means that spirituality and
mentality are an essential part of health.
Healthy body depends on good spirituality
and mentality.
o That is why the Taoist Zhuangzi (莊子) said:
nothing is more lamentable than a dead
heart (哀莫大於心死).

Why heartbroken, but not

“brainbroken”
o Ancient doctors, regardless of Chinese or
Western, have observed the phenomenon that
all spiritual and mental activities are gone when
person’s heart stopped beating.
o Although they might have elementary
anatomical knowledge about the brain, they
should have least knowledge about the brain
function. They “mistakenly” regarded the heart
as the organ of controlling human emotion and
cognition. That is why today we still say
heartbroken (心碎) rather than “brainbroken”
(腦碎)。

7
Anatomic diagram of the
heart in TCM

《存真圖》之心臟

Anatomic diagram of the

brain in TCM

brain
brain

《存真圖》之腦

8
 The heart or the brain controls
our mind and spirit?

Shen (神) is a superhuman in

ancient Chinese philosophy
o Shen (神) is a Chinese Jinni or manitou (圖騰)
in ancient times. Ancient Chinese believes
Shen is a superhuman who controls birth
and old age, sickness and death (生老病死) of
all the human and the nature.
o An ancient Chinese philosopher said that
The Heaven and the Earth produce all
substances that is controlled by a
superhuman, called Shen (天地生萬物, 物有主
元者曰神).

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 What Shen (神) means in TCM

o TCM-based Shen indicates the

brain function, in particular
mentality and spirituality.
o So it can be translated as the
Spirit (broad sense) or the Mind
(narrow sense) in English.

Two meanings of Shen (神) in TCM

o The broad sense of Spirit is the Heart-Spirit (心

神) that indicates the activity of thinking,
consciousness, insight, and memory. We often
say that you do not waste too much Heart-
spirit to deal that thing (你不要費太多心神去處理
那件事)。
o The narrow sense of the Spirit indicates the
five mental-spiritual aspects (五神), the Mind
(神), the Ethereal Soul (魄), the Corporeal Soul
(魂), the Intellect (意), and the Will-Power (志).

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 Five-spirit corresponds the five
internal organs (五神對五臟)
o Mind (SHEN, 神) – Heart
o Ethereal Soul (HUN, 魂) – Liver
o Corporeal Soul (PO, 魄) – Lungs
o Intellect (YI, 意) – Spleen
o Will-Power (ZHI, 志) - Kidneys
o Although the doctrine of five-spirit with five
organs may be very elementary, ancient
physicians have realized an association of
psychological activities with the body
physiological functions.

The Three Treasures (三寶)

o The three treasures are the Essence (精),

vital energy (Qi, 氣), and the Mind (神).
n The Essence is the genetic substances
that are inherited from the parents.
n Qi represents a variety of biological and
physiological functions of human body.
n The Mind is the most subtle and non-
material, representing mental and
spiritual activities.

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 Relationships of the Three
Treasures (三寶)
The Essence and Qi are the
The Mind
origin and biological basis of
(神)
the Mind. If the Essence and
Qi are strong, the Spirit will be
The QI happy and the mind is sharp.
(Energy, 气) In other words, happy spirit
largely depends on the
completeness of the pre-natal
The Essence substances (先天之本) and
(精)
post-natal nutrition (後天之養).

The Heart-Mind (心神) yields the

following capacities:
o Consciousness (醒) o Wisdom (慧)
o Sleep (寐) o Ideas (意)
o Intelligence (智) o Pensiveness (思)
o Memory (記) o Thinking (想)
o Insight (悟)

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The Ethereal Soul (魂)
o Chinese Character (魂) is composed of
雲 (cloud) and 鬼 (ghost). The ghost
(鬼) is composed of two parts:
n “由” is a head without body;
n “尤” is a swirling movement.
o This ancient radical depicts the
bodiless head of a dead person flying
to Heaven in a swirling movement.

The Ethereal Soul (魂)

o Balance courage and cowardice.

o Modulate sleep and dreaming (day
dreaming).
o Balance excitation and restraint of
emotional life.
o Yield the capacity of planning.
o Produce vision and insight.

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 The Corporeal Soul (魄)

o The Corporeal Soul is a somatic

expression of the soul.
o It is the part of the soul (as opposed
to the Ethereal soul), which is
indissolubly attached to the body
and goes down to the Earth as
death.

Function of the
Corporeal Soul (魄)
o Give us the capacity of sensation,
feeling, hearing, sight.
o give the capacity of movement,
agility, balance, and coordination
of movement.

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 The Intellect (意) and
Will-Power (志)

o Thinking
o Remembering
o Memorizing
o Decision-making

Seven emotions and six desires

(七情六欲)

o Seven emotions (七情): o Six desires (六欲):

n Anger (怒) n Vision (色)
n Happiness (喜) n Hear (聲)
n Pensiveness (思) n Smell (香)
n Sadness (悲) n Taste (味)
n Fear (恐) n Touching (觸)
n Worry (憂) n Desire of life (生)
n Shock (驚)

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 Five emotions corresponds the five
internal organs (五情對五臟)
o Anger (怒) – Liver
o Happiness (喜) – Heart
o Pensiveness (思) – Spleen
o Sadness (悲) – Lungs
o Fear (恐) - Kidneys
o The doctrine of five emotions with five
organs suggests that excessive activity of an
emotion may specifically affect certain body
system.

TCM-described mental-
emotional symptoms
o Insomnia (不寐) o Suicidal thoughts (欲死)
o Tiredness (疲憊) o Loss of interest (失趣)
o Fatigue (虛勞) o Loss of insight (失悟)
o Sadness (鬱鬱寡歡) o Easily lose temper (易怒)
o Concentration o Nervousness (心神不安)
difficulties (走神) o Anxiousness (惶惶不安)
o Hopelessness (無望) o Easily worrisome (憂心忡
o Helplessness (無助) 忡)
o Agitation (坐臥不寧)
o Easily tear or cry (黯
然淚下) o Hallucination (幻聽幻視)

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Mental-emotional illnesses in
modern psychiatry
o Depression (抑鬱症)
o Generalized anxiety (廣泛性焦慮症)
o Panic disorders (驚恐症)
o Social phobia (社交焦慮症)
o Obsessive-compulsive disorder (OCD, 強迫症)
o Posttraumatic stress disorders (PTSD, 創傷後應激
障礙)
o Manic-depressive (bipolar) disorder (躁狂抑鬱(雙
相)障礙)
o Schizophrenia (精神分裂症或思覺失調)
o Suicide (自殺)

Do you have depressive

symptoms?

Let us do a 10-item
questionnaire.

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 Question #1

Do you often feel sad or

irritable?

Yes No

Question #2

Have you lost interest in

activities once enjoyed?

Yes No

18
 Question #3

Have you experienced changes

in weight or appetite?

Yes No

Question #4

Have you experienced

changes in sleeping pattern?

Yes No

19
 Question #5

Do you have feelings of

guilt?

Yes No

Question #6

Are you unable to concentrate,

remember things, or make
decisions?

Yes No

20
 Question #7

Have you experienced

fatigue or loss of energy?

Yes No

Question #8

Have you experienced

restlessness or decreased
activity noticed by others?

Yes No

21
 Question #9

Do you feel hopeless or

worthless?

Yes No

Question #10

Have you had thoughts or

attempts of suicide or death?

Yes No

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 Self Assessment

If you have 5 or more yes

answers, you may be
suffering from clinical
depression.

Treating mental illnesses

in early days of European

Drilling holes (腦部鑽孔)

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 Treating manic patients in
early days

o Nothing can do
but restraining
patients with
metal chains

Psychotropic drugs are the mainstay

for mental illnesses today

o Over-prescription of
psychiatric medication has
become a big issue in the
modern society:
n Anxiolytic (抗焦慮藥)
n Mood stabilizers (心境穩定劑)
n Antidepressants (抗抑鬱藥,
血清素)
n Antipsychotic (抗精神病藥)

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 Shortcomings of psychiatric
medication

p Limited efficacy (有限的療效)

p Tolerance (耐藥性)
p Addiction and physical
dependence (依賴性)
p Adverse side effects (副作用)

Can traditional Chinese medicine (TCM)

do something in today mental healthcare?

‘‘Refractory” or severe
psychiatric illnesses TCM may serve as adjunctive or
(schizophrenia, bipolar additional therapy
disorders, etc.)

‘‘Curable” or moderate TCM also has a significant

mental- emotional role in treating the moderate
problems: problems.

Population without or TCM has an important role in

with mild mental- preventing and treating the
emotional problems mild problems.

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 Prevention is a fundamental
philosophy of TCM

p Ancient Chinese physicians said that the

best of best physicians should consider
preventing the occurrence of the illness as
first priority, rather than merely dealing
when the illness occurs.
上工不治已病治未病
p The concept of not-yet-ill (NYI) (治未病) has
been widely recognized in today healthcare.

Traditional Chinese healing arts

for mental health
n Chinese herbal medicines (草藥)
n Chinese dietary therapy (藥膳療法)
n Acupuncture and related therapies (針灸)
n Tui-na and massage (推拿和按摩)
n Aromatherapy (芳香療法)
n Qi Gong and Chinese traditional exercises
(中國氣功)
n TCM psychological consultant (中醫心理療法)
n Chinese music therapy (中國音樂療法)
n Laughter and humor therapy (笑聲和幽默療法)

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 Chinese Herbal Medicine

o There have been a large number of

herbal medicines which habituate in
China, India, Japan, Europe, South
America, and Africa may benefit mental
and emotional problems.
o Here is a list of commonly Chinese and
other herbal medicines:

Suanzaoren (酸棗仁, Ziziphus jujuba)

It can calm anxiousness

(焦慮) and improve sleep
quality.

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Yuanzhi (遠志), Polygala tenuifolia

As a sedative for
neurasthenia (神經衰弱)
and insomnia (失眠).

Hehuan (合歡) Silktree Siris

It can be used for the treatment

of restlessness and insomnia.

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Lingzhi (靈芝), Ganoderma lucidum

o Dizziness
o Palpitation
o Depressed
o Insomnia
o Weakness

St. John’s Wort (貫葉連翹)

(Hypericum perforatum)

Clinical trials have demonstrated the

treatment benefits in patients with
mild to moderate depression.

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 Ginkgo (銀杏葉)

Its products are beneficial in

improving learning and memory and
alleviating dementia symptoms.

TCM formula: Free and Easy

Wanderer Plus (FEWP, 加味逍遙散)

Our clinical studies have confirmed

the effectiveness of FEWP in
patients with depression.

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 Main indications for FEWP
(加味逍遙散)

o Depression
o Premenstrual syndrome
o Anxiety
o Menopause syndrome
o Blue mood in postpartum women

TCM dietary therapy (食療) –

eating healthily
o Diet therapy is an important part of
TCM. TCM dietary therapy is based on
the concept of “drug and food share
the same resources” (藥食同源).

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 Aims of TCM dietary therapy

o Preserve and improve health

conditions.
o As complimentary therapy to
treat diseases.
o Rehabilitation

Chinese dietary Philosophy (1)

p Confucian said: eat no rice but is of the
finest quality, nor meat but is finely
minced (食不厭精，膾不厭細). It means that
foods should be made to be well digestible
and mostly preservable in nutrition.
p Balance the five flavors of foods
(謹和五味). It means that one
should have diverse foods.
p regularly take a limited
amount of food (定時定量).

32
Chinese dietary Philosophy (2)

p Never over eat, better eat a 70% of

amount you can (七分飽, 三分餓).
p Take high-quality breakfast, sufficient
lunch, and light supper (早餐吃好, 中飯吃
飽，晚飯吃少).
p Enjoy food by chewing
sufficiently and
swallowing slowly
(慢嚼細咽).

Tea: not only soft drink

o Tea has nutritional and pharmacological effects:
n Wake up and elevate alert.
n Improve appetite and digestive functions.
n strengthen cardiovascular functions.
n prevent cancer and radiations diseases.
o Green tea: cold in nature, remove heat, good in
summer season.
o Black tea: warm in nature, warm the stomach
(溫中健胃). Good in winter season.
o Scented tea: moderate in nature, is good for all
seasons.

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 Caution of taking tea
o Avoid drinking concentrated tea
before bedtime.
o Black and strong tea is not suitable
for those who have problems in
falling in sleep, peptic ulcer and
habitual constipation.
o Drug and tea never be taken together.

Alcohol in TCM
o In ancient China, alcohol was considered as
medicine. The Chinese word “醫”(medicine) is
composed of “酉” that is alcohol. Many
Chinese medicines are prepared with alcohol,
which is called medicated wine (藥酒).
Medicated wines can be used to:
n Remove pathogenic wind, cold and
dampness (驅風寒濕).
n Warm spleen and stomach (溫暖脾胃).
n improve blood circulation and meridians
(活血通絡).

34
 Young people and alcohol
o Only drink in social occasion with a
limited amount.
o Never drink to release your anxiousness,
depression and helplessness.
o Never drink when you have liver
diseases (肝病), kidney diseases(腎病),
diabetes (糖尿病), hypertension (高血壓),
and other diseases.

Acupuncture

o Depression (抑鬱症)
o Generalized anxiety
disorders (GAD, 廣泛性
焦慮症)
o Panic disorders (驚恐症)
o OCD (強迫症)
o Insomnia (失眠症)

35
 Dr. ZJ Zhang’s
De-stress Acupressure

p Knead Yintang 拿捏印堂

p Knead Taiyang 壓揉太陽
p Press Fengchi 按揉風池
p Hold the waist 環抱腰部
p Rub the abdomen 揉摩中腹

Knead Yintang 拿捏印堂

36
Knead Taiyang 壓揉太陽

Press Fengchi 按揉風池

37
Holding the waist 環抱腰部

Rub the abdomen 揉摩中腹

38
Benefits of ZJ Zhang’s De-stress
Acupressure
o Reduce anxious mood
o Improve your sleep
o Help forget unhappy things
o Reduce your headache
o Reduce your tension neck
o Help lose your body weight
o Maintain good body shape

Tui-Na (推拿)
o Tui-Na is an ancient Chinese bodywork for
wellbeing and therapeutic purpose. It is often
used for physical and mental relaxing.
o Commonly used Tui-Na techniques:
n Gliding (推)
n Rotation (滾)
n Kneading (捏)
n Rocking (搖)
n Percussion (拍)
n Vibration (抖)
n Friction (擦)
n Shaking (顫)
n Pulling (拔)

39
 Spa aromatherapy (芳香療法)

o It is an external approach to prevent and

treat diseases by fumigating and bathing
local and whole body using herbal
medicine, particularly aromatic herbs,
mainly including:
n Fumigating and steam (sauna, 薰蒸)
n Body bathing (洗浴)
n Macerating (浸泡)
n Sitz bath (坐浴)

Some commonly used aromatic

materials for calming nerves
o Lemon balm (檸檬): lift spirits.
o Geranium (香葉油): deeply relax
mood.
o Lavender (熏衣草): relax
muscles.
o Chamomile (甘菊): calm nerves.
o Sandalwood (檀香): reduce
tension and anxiety.
o Bergamot (佛手柑香油): calm
nerves
o Frankincense (乳香): produce a
meditation state.

40
 Qi Gong (氣功)
n Qigong is a traditional Chinese practice of
aligning breath, movement, and awareness
for exercise, healing, and meditation. It
roots in Chinese medicine, martial arts, and
philosophy.
n It involves rhythmic breathing coordinated
with slowly stylized movement, a calm
mindful state, and visualization of guiding
Qi through the body.

How exercise therapy works

o Maximize physical abilities by

Improving muscular, cardiovascular,
and nervous function.
o Improve respiratory function and
increase lung capacity.
o Harmonizing the mind and body.
o Improve physical and mental health
and wellbeing.

41
 Principles and requirements of
Qigong exercise therapy

o Quiescent and dynamic

exercises
o Keep doing exercise daily
o Harmonize limbic
movement and breathing

http://www.youtube.com/watch?v=hYZDOpHYgLM

Traditional Chinese
Qigong exercises
o Taichi (太極拳)
o Eight-section exercise (Ba-
Duan-Jin, 八段錦)
o Five-Animal mimicking exercise
(Wu-Qin-Xi, 五禽戲)

42
We are doing 八段錦

We are doing 八段錦

43
 Buddhism
Meditation (坐禪)
n Buddhist meditation is
a meditative practice associated
with the religion and philosophy
of Buddhism, with an aim to develop
mindfulness, concentration, powers, and
insight.
n In meditation practice, one pays attention to
his/her present emotions, thoughts and body
sensations, such as breathing, without passing
judgment or reacting. An individual simply
releases his thoughts and "lets it go”.

Principles of TCM
psychological therapy
n Grief antagonizes Anger
n Fear antagonizes over-joy
n Anger antagonizes over-brooding
n Joy antagonizes worry
n Pensiveness antagonizes fear
p “悲勝怒、恐勝喜、怒勝思、喜勝憂、思勝恐”.
p “悲可以治怒，以愴惻苦楚之言感之；恐可以治悲，
以謔浪褻狎之言娛之，恐可以治喜，以迫遽死亡之言
怖之；怒可以治思，以污辱期罔之言觸之；思可以治
恐，以慮彼思此之言奪之。

44
中醫心理療法 怒(肝)

恐(腎) 喜(心)
p 悲勝怒
p 恐勝喜
p 怒勝思
p 喜勝憂
p 思勝恐 悲(肺) 思(脾)
相生 相克
p 悲可以治怒，以愴惻苦楚之言感之；恐可以治悲，以謔浪褻狎
之言娛之；恐可以治喜，以迫遽死亡之言怖之；怒可以治思，
以污辱期罔之言觸之；思可以治恐，以慮彼思此之言奪之。

“Pounding the table” therapy for PTSD

One night, a robber invaded a woman’s

bedroom. She was scared and fallen from
bed. Since then, she was traumatized by
any noises, even her family members’
footsteps. Following careful evaluation, Dr.
Zhang asked two assistants to help fix her
on high chair and placed a bamboo-made
tea table on her front. Dr. Zhang then ZHANG Zihe
repeatedly pounded the table using a (1156-1228)
wooden stick. At the beginning, the woman
was frightened, but gradually got used to it,
eventually recovering from trauma.
Cognitive behavioral therapy (CBT)?

45
 中醫心理療法治療神志病 Psychological
therapy for mental diseases

o 張子和(1156-1228): 擊幾療驚悸
衛德新之妻，夜間因遇盜賊驚嚇墜于
床下，遂懼怕聲響，甚至聽到家人的
腳步聲都會“驚倒不知人”。張從正
思考再三，乃命二侍女將患者兩手按
在高椅上，在其面前置一竹幾，用木
棍反復敲擊。病婦開始聽到敲擊聲膽
戰心驚，連續敲擊後，便習以為常。

Chinese Music therapy

(音樂療法)

p TCM patterns have been used in early times to

select music which aid in bringing the body back
into balance.
p TCM music is based on the doctrine of the mean
and strives to achieve harmony with heaven,
earth, and the human body via music. There is a
Chinese saying: “Harmony between music and
man, harmony between heaven and man” (樂與人
和, 天人合一), and this is believed to be the ideal
state.
http://www.youtube.com/watch?v=wdk5tAVNY1Q

46
 The five sounds correspond to the
the five internal organs
o Lung (肺) – Sadness (悲) – Shang (商)
o Liver (肝) – Anger (怒) – Jiao (角)
o kidney (腎) – Worry (恐) – Yu (羽)
o Heart (心) – Joy (喜) – Zheng (徵)
o Spleen (脾) – Pensiveness (思) – Gong (宮)
n It means that music can
regulate human mood activity
and physiological functions of
internal organs.

情志養生：音樂療法
o 宮–脾–思
o 商–肺–悲
o 角–肝–怒
o 羽–腎–恐
o 征–心–喜
p 脾應宮，其聲漫而緩；肺應商，其聲促以清；
肝應角，其聲呼以長；心應徵，其聲雄以明；
腎應羽，其聲沉以細，此為五臟正音。

五音應五臟,五音調五志

47
Prevention of Dementia (防治癡呆)
p Yoga 瑜伽
p Tai-chi 太極拳
p Meditation 冥思
p Acupuncture 針灸
p Diet 食療
p Chorus singing 合唱
p Cross-word puzzles 文字遊戲
p Swimming 游泳
p Play Ma-Jiang 打麻將?
p Plaza Dancing 廣場舞？
Ashford et al., 2015; Zhou et al., 2015

Laughter and humor

therapy (笑聲和幽默療法)

p Humor can be defined as that

makes us laugh, smile, or
amuses us. Laughter is the best
medicine for releasing stress:
n Enhances respiration.
n Enhances circulation.
n Oxygenates the blood.
n Suppresses stress-related
hormones, activates the
immune system.

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 笑聲和幽默療法
Laughter and humor therapy

p Laughing is best medicine.

p 歡樂和笑聲是最好的醫藥.
p 笑一笑，十年少。
p 《儒門事親》：喜者少病，百脈
舒和故也。

Laughing is the best medicine

o The average pre-schooler laughs or

smiles 400 times a day and that number
drops to 15 times a day by age 35.
o People smile only 35% as much as they
think they do.
o Laughter releases endorphins, a chemical
more powerful than morphine.
o Every time you laugh you burn 3.5
calories.
http://www.youtube.com/watch?v=RP4abiHdQpc

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 Why humor can improve your
mental health
p Breaks up boredom and fatigue, reduces conflict
and tension.
p Fulfills social needs for mastery and control.
p Improves communication.
o At the moment we experience humor, feelings
like depression, anger and anxiety are gone.

http://www.youtube.com/watch?v=ZWCSQm86UB4

Be Happy, Be healthy,
If unhappy, contact me:

Zhang-Jin Zhang
E-mail: zhangzj@hku.hk
Tel: 3917-6445
Thank you!

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