Acute vs constitutional treatment with herbs

Generally speaking the point of all Chinese Medicine treatment is to treat the root imbalance or the constitutional issues instead of working symptomatically. That said many modern people will appear clinically with very split patterns (i.e. generally signs of both yin and yang deficiency, but more complicated in a clinical setting). Newer formulas, then, are designed to help account for these newer patterns in modern western patients. For some, and in some cases, the traditional formulas will work better than their modern adaptations but the deeper "constitutional" goal of all of them is generally the same.

The two main ways to evaluate herbal formulas are to first look at their individual ingredients and second to better understand which tcm patterns they are best for. As modern manufacturers like to place english names in various formulas the lines between using herbal formulas properly for appropriate tcm patterns and using their for symptoms gets blurred and is often the cause of inferior results or side effects.

CZ for example is a modern formula created by an accomplished western herbalist Dr. Ming Wu. It is composed of the following herbs:

<ul>
<li>
Magnetitum (Ci Shi) - Anchors and calms the spirit - restlessness, palpitations, insomnia, tremors, especially with yin deficiency and ascending yang, dizziness, vertigo.</li>
<li>
Leonuri Fruits (Motherwort / Yi Mu Cao) - Invigorates blood and regulates menses for gynecological issues - PMS, abdominal pain, irregular menses, abdominal masses, infertility, post partum abdominal pain w/lochioschesis, stasis from blood deficiency.</li>
<li>
Chen Chu (Pearl Powder/ Zhen Zhu) - Sedates the heart - tremor, palpitations, seizures, childhood convulsions.</li>
<li>
Ostreae Testa (Oyster Shell / Mu Li) - Calms the spirit - palpitations, anxiety, restlessness, insomnia. Benefits the yin, anchors floating yang - irritable, insomnia, dizziness, headache, tinnitus, blurred vision, bad temper, red flushed face due to yin deficiency with ascending yang.</li>
</ul>

So that formula has stronger aspects for sedating the spirit which could be seen as slightly more "symptomatic" and generally you can use this formula this way, but the herbs themselves are very constitutional for heart yin deficiency and yang rising and other patterns.

Herbal treatment at times will follow a progression from clearing the more acute/serious aspects of various patterns which may often clear quickly then more middle of the road formulas will be used to create more stability in the person to avoid recurrences. For example as signs of heat dissipate (red tongue, irritability, etc.), then herbs which clear heat will only weaken the person. So there is a time and a place for everything, but the some formulas are better for more acute issues and used over the short term and others are better over the long term.

So to answer your question more specifically for someone with underlying yin deficiency that has been prolonged and led to an unsettled spirit you could use CZ for awhile to settle and anchor the spirit through the mechanisms of the herbs listed above and then possibly switch to a formula such as liu wei di huang wan which will work on strengthening the underlying causal factors to avoid this pattern getting out of control in the future - or they may be used together in certain settings to accomplish both at the same time.

Another commonly used progressive set of herbs for liver qi stagnation with similar anxiety symptoms might be to use chai hu long gu mu li wan to more strongly settle the spirit and deal with the underlying liver stagnation and then switch to xiao yao wan as a more mild balancer to continuing resolving the causal factors and avoid recurrence.