Treating Depression with the Teachings of Sage Physician Zhang Zhongjing: A Single Dose of Lily and Rehmannia Decoction to Calm the Spirit, Relieve Depression, and Nourish the Heart Yin

An Ancient Formula for Healing the Heart from Depression, Anxiety, and Insomnia

The “Heart Fire” That Keeps You Up at NightLast week, a 35-year-old female patient came to my clinic. Her brows were tightly furrowed, and as soon as she entered, she said, “Doctor, I feel like I’m carrying a rock on my back every day. I can’t sleep, I want to cry, and I’m afraid to see people…”

Her pulse was thin and rapid, her tongue red with little coating — a classic presentation of “Lily Disease.”

It immediately reminded me of a line from Jingui Yaolue by Zhang Zhongjing:

“Wants to eat but cannot, often silent, wants to lie down but cannot... as if possessed by a spirit.”

Over 2,000 years ago, Zhang Zhongjing had already grasped the subtle mechanisms behind what we now call depression. When the heart and lung yin are deficient, internal heat builds up, blood flow is disturbed, and the spirit cannot rest.

1. The Nature of Depression and Anxiety: Yin Deficiency with Excessive Internal Fire

Though her symptoms appeared complex, at their root, it all came down to one issue: “Heart Yin Deficiency.”

When a person overthinks for a long time, the heart’s blood becomes depleted. Emotional stagnation can turn into fire, disturbing the yin. When the spirit loses its home, insomnia, fearfulness, and mental unrest follow.

Zhang Zhongjing’s wisdom lies in not merely calming the spirit but using a dual approach: nourishing yin and clearing heat — like rain gently soaking a parched land.

2. Lily and Rehmannia Decoction: Zhang Zhongjing’s “Soul Repair Formula”

Formula:

• Lily (30g): Moistens the lungs and clears the heart; especially helpful for irritability and the inability to sleep. Lily nourishes lung yin and clears lung heat, restoring normal lung function.

• Raw Rehmannia (15g): Nourishes kidney water and reduces heart fire; targets red tongue with little coating. Rehmannia replenishes heart yin and blood, clears blood heat, and nourishes the heart vessels.

(Traditionally decocted with spring water, now can be made with clean water.)

Patient Feedback:After one week, she returned for follow-up with brighter eyes:

“I can sleep 4 hours now! The burning heat in my chest is mostly gone.”

After adjusting the dose and continuing for another two weeks, her mood became stable and she even began going out for walks.

3. Clinical Insights: Treating Depression is Like “Changing Fuel for the Heart”

1. Not all depression suits this formula ❗️

• Suitable for: Yin-deficient types (dry mouth, night sweats, red tongue)

• Avoid for: Damp-phlegm types (thick greasy tongue coating), yang-deficient types who fear cold

2. Diet Tips 🍐

• Combine with lily and lotus seed porridge

• Avoid spicy food, coffee, and other heat-producing items

3. More important than medicine ❤️

"This formula treats the symptoms, but heart care heals the root."

I often tell patients:

• Get morning sun to raise yang qi, take brisk walks in the evening to release emotions

• Practice yoga, Tai Chi, or Baduanjin (Eight Brocades)

• Write in a “mood journal” before bed to release stress

Watching patients leave with lighter steps always reminds me of a quote from the Preface to the Treatise on Cold Damage:

“To treat the illness of rulers and parents above; to rescue the hardship of the poor and humble below.”

The pain of depression is no different between ancient and modern times. The beauty of Lily and Rehmannia Decoction lies in its gentle way of nourishing the withered heart, not suppressing emotions.

Depression can be healed — as long as we identify the root cause and use the right treatment. If someone you know is struggling with depression, feel free to reach out. I’m happy to help.