Susceptibility+to+Fear+and+Fright+(Shan+Kong,+Shan+Jing)

Susceptibility to fear, //Shan Kong//, Refers to an emotional state characterized by anticipation of the feeling of pain or danger which is often unreasonable or groundless. In other words, it refers to fear of something which is not currently present but which causes fear about the future. Paranoia is a form of this disorder.

Susceptibility to fright, //Shan Jing//, describes the emotional state of being easily frightened y minor stimuli or even frightened by nothing. People with the Chinese concept of susceptibility to fright startle more easily than most other people

Western Psychiatric Conditions Associated with Fear and Fright:
 * Susceptibility to fear:**
 * 1) Generalized anxiety
 * 2) Agoraphobia
 * 3) Psychosis with anxiety
 * 4) Adjustment disorder with anxiety
 * 5) Specific social phobias
 * Susceptibility to fright:**
 * 1) Panic attacks, triggered
 * 2) Panic Disorder, triggered
 * 3) Post-traumatic stress disorder (PTSD)
 * 4) Phobias with panic symptoms

Diagnosis: A. Moody, requent emotional changes B. Improper emotional expression C. Long-term emotional stimulant and stressor D. Acute emotional outburst Should have any one of the above

Prognosis: In almost all cases of this disorder will get better after the factors or stressors have been relieved. Exempting the emotional change as a preliminary sign for some severe Shen disturbance disease, in general this disease can be treated and cured in a scheduled treatment plan including Shen treatment techniques.

Differential Diagnosis: Medical Disorders: Effects of Substances: Psychiatric Disorders:
 * 1) Neurologic Disorders
 * 2) Endocrinologic Disorders
 * 3) Toxic Exposure
 * 4) Miscellaneous other medical disorders
 * 1) Alcohol or illicit substance intoxication or withdrawal
 * 2) Side effects or discontinuation effects on mediation
 * 1) Panic disorder with or without agoraphobia
 * 2) Social phobia
 * 3) Specific phobias
 * 4) Post-traumatic Stress Disorder (PTSD)
 * 5) Generalized Anxiety Disorder (GAD)
 * 6) Schizophrenia and other psychotic disorders
 * 7) Personality Disorders

TCM Etiology and Pathogenesis: Fear is the affect associated with the kidneys. Therefore, kidney vacuity may manifest as susceptibility to fear. Former heaven natural endowment insufficiency, immaturity or aging, enduring disease, over-taxation, unrestrained sexual activity, and over-use of certain medicines and drugs may consume the essence and cause kidney essence insufficiency, thus resulting in susceptibility to fear

In the case of susceptibility to fright, there is an exaggerated startle reflex. Such startling is considered a species of stirring, and stirring always involves a movement of Qi in Chinese medicine. TCM Pattern Differentiation: Kidney Essence Insufficiency 1,2 Susceptibility to fear, heart palpitations, low back and knee soreness and limpness, lassitude of the spirit, dizziness, tinnitus, feeling like head is empty, heart vexation, reduced sleep, seminal emission, night sweats, may have long disease history -BL-15, BL-23, BL-52, KI-3, SP-6. Draining technique1 -KI-3, KI-7, KI-9, KI-27, CV-4, CV-6, CV-17, CV-21, LU-9, GV-20 2 - [Shu Di Huang, Shan Yao, Huang Qi, Du Zhong, Xu Duan, Jin Ying Zi, Qian Shi, Tu Si Zi, Suan Zao Ren]2 Severe night sweats, insomnia, profuse dreams1: + Suan Zao Ren, Bai Zi Ren Kidney Yang vacuity w/ impotence, seminal emis1 sion, and chilled limbs: + Lu Jiao, Rou Gui
 * Tongue:** red tongue, scanty coat
 * Pulse:** Fine, weak
 * Treatment Principles:** Supplement the kidneys, fill the essence, and fortify the mind
 * Acupuncture Treatment:**
 * Herbal Treatment:**
 * -**Liu Wei Di Huang Wan Jia Wei - [Shu Di (15g.), Shan Zhu Yu (12g.), Shan Yao (12g.), Fu Ling (10g.), Ze Xie (6g.), Dan Pi (10g.), Yuan Zhi (10g.), Gui Qi ZI (10g.), Mai Dong (10g.), Wu Wei Zi (10g.)]1
 * Modifications:**

Qi & Blood Dual Vacuity 1,2 Intermittent susceptibility to fear, heart palpitations, shortness of breath, pale white facial complexion, pale lips and nails, fatigue, lack of strength, aversion to wind, spontaneous perspiration -HT-7, BL-15, Sp-6, ST-36, BL-17. Tonifying technique1 -CV-4, CV-6, CV-17, HT-7, SP-6, SP-10, ST-36, KI-3, KI-7, GV-202 Ba Zhen Tang Jia Wei1 - [Dang Shen (10g.), Bai Zhu (10g.), Fu Ling (10g.), Shu Di (12g.), Bai Shao (10g.), Dang Gui (10g.), Chuan Xiong (6-10g.), Shi Chang Pu (6g.), Yuan Zhi (6g.)] 1 -[Shu Di Huang, Bai Shao, Chuan Xiong, Dang Gui, Ren Shen, Bai Zhu, Fu Ling, Gan Cao, Long Yan Rou, Mu Xiang, Gou Qi Zi]2 Insomnia1: + Suan Zao Ren, Fu Shen Spontaneous sweating1: + Huang Qi, Fu Xiao Mai
 * Tongue:** pale tongue, thin coat
 * Pulse:** Fine, weak
 * Treatment Principles:** Supplement the Qi, nourish the blood, and quiet the spirit
 * Acupuncture Treatment:**
 * Herbal Treatment:**
 * Modifications:**

Heart-Gallbladder Qi Vacuity 1,2 Timidity, paranoia, susceptibility to fear and fright, indecisiveness when decision-making is needed, inability to control oneself,, dislike to meet people or dating, prone to being startled, sensitive to some sound and light, headache, rib-side discomfort, heart palpitations, possible heart vexation and/or insomnia, profuse dreams, possible profuse phlegm and/or plum pit Qi, low appetite, menstrual disorders -GV-24, GB-35, LR-14, LR-13, CV-4. Even technique1 -LR-3, LR-8, LR-13, LR-14, GB-5, GB-8, GB-13, GB-24, GB-402 -[Dang Gui, Huang Qi, Fu Shen, Bai Shao, Chai Hu, Dang Shen, Yuan Zhi, Shi Cang Pu, Chen Pi, Suan Zao Ren, Mu Xiang] 2
 * Tongue:** pale tongue, thin coat
 * Pulse:** slightly bowstring, weak, possibly slippery or soft
 * Treatment Principles:** Supplement the Qi, nourish the heart, and quiet the gallbladder
 * Acupuncture Treatment:**
 * Herbal Treatment:**
 * -**Shi Wei Wen Dan Tang1 - [Dang Shen (10g.), Fu Ling (10g.), Zhi Gan Cao (3-10g.), Chen Pi (6g.), Ban Xia (10g.), Yuan Zhi (10g.), Suan Zao Ren (12g.), Zhi Shi (6g.), Shu Di (12g.), Wu Wei Zi (10g.)] 1

Liver Depression Blood Vacuity 1 Susceptibility to fright, irritability, vexation and agitation, breast, chest, abdominal, and rib-ide distention and fullness especially during the premenstrum, dizziness, headache, moodiness, pale white facial complexion and pale nails, scanty, delayed, or blocked menstruation in females [Chai Hu (10g.), Dang Gui (10g.), Bao Shao (10g.), Bai Zhu (10g.), Fu Ling (10g.), Gan Cao (6g.), Bo He (3-6g.), Sheng Jiang (3g.), Da Zao (3 pieces), Long Gu (12g.), Mu Li (12g.)] Severe blood vacuity: + Shu Di Liver depression transforming into fire w/ dryness and bitter taste in mouth, red eyes, and severe susceptibility to fright:-Bo He, Sheng Jiang; + Zhi Zi, Dan Pi Severe breat or rib-side distention and pain: + Chuan Lian Zi, Yan Hu Suo
 * Tongue:** pale tongue, thin coat
 * Pulse:** fine, bowstring
 * Treatment Principles:** Course the liver and rectify the Qi, nourish the blood and quiet the spirit
 * Acupuncture Treatment:** PC-7, PC-6, LR-3, LR-14, St-36. Even technique
 * Herbal Treatment:** Xiao Yao San1
 * Modifications:**

Liver Blood-Kidney Yin Vacuity 1 Susceptibility to fright, vexation, reduced sleep, pale white facial complexion, dizziness, lower back pain, afternoon tidal heat, night sweats, 5-palm heat [Dang Gui (10g.), Bao Shao (10g.), Shu Di (12g.), Shan Yao (10g.), Fu Shen (10g.), Sha Zhu Yu (10g.), Ze Xie (6g.), Dan Pi (6-10g.), Suan Zao Ren (12g.), Bai Zi Ren (12g.)] Marked deficiency heat: + Zhi Mu, Huang Bai
 * Tongue:** red or pale tongue, red tip
 * Pulse:** fine, bowstring, possibly rapid
 * Treatment Principles:** Nourish the blood and enrich Yin, quiet the spirit and relieve fright
 * Acupuncture Treatment:** HT-6, BL-15, BL-17, BL-18, SP-6, KI-3. Even technique
 * Herbal Treatment:** Gui Shao Di Huang Tang Jia Jian1
 * Modifications:**

Phlegm Fire Harassing Above 1 Susceptibility to fright, heart palpitations, vertigo and dizziness, vexation, insomnia, headache, dryness and bitterness in the mouth, profuse commonly yellow phlegm [Ban Xia (10g.), Zhu Ru (10g.), Zhi Shi (6g.), Chen Pi (6-10g.), Fu Ling (10g.), Huang Lian (3-6g.), Gan Cao (3g.)] Concomitant liver depression: + Chai Hu, Chuan Lian Zi Vomiting: + Pi Pa Ye, increase Zhu Ru Severe fright: + Mu Li, Long Gu
 * Tongue:** red tongue, slippery yellow coat
 * Pulse:** slippery, rapid
 * Treatment Principles:** Clear heat and transform phlegm, quiet the heart and calm the spirit
 * Acupuncture Treatment:** PC-7, GB-41, CV-12, St-40. Draining technique
 * Herbal Treatment:** Huang Lian Wen Tang1
 * Modifications:**

Heart Fire Effulgence 1 Susceptibility to fright, heart vexation, flushed red facial complexion, red eyes, sores in the mouth and on tip of the tongue, preference for chilled drinks, disturbed sleep, difficult burning dark-colored urination [Mu Tong (5g.), Sheng Di (12g.), Huang Lian (6g.), Zhu Ye (10g.), Deng Xin Cao (3g.), Lian Xin (3g.), Long Chi (12g.), Zhen Zhu Mu (12g.), Gan Cao (6g.)]
 * Tongue:** red tongue, thin yellow coat
 * Pulse:** rapid
 * Treatment Principles:** Clear the heat, discharge fire, and relieve fright
 * Acupuncture Treatment:** PC-8, SI-7, HT-7, KI-4. Draining technique
 * Herbal Treatment:** Xie Xin Dao Chi San Jia Jian1