Tinnitus is a sound sensation in the ear or skull that occurs over a certain period of time when no external acoustic or electrical stimulation is applied. Tinnitus is not only a clinical symptom, but also an independent disease. In recent years, with the development of modern society, the accelerated pace of life and the increase in work pressure, the incidence of tinnitus has been increasing year by year. Clinically, tinnitus is a difficult disease to treat.
The diagnosis and treatment of tinnitus is a world problem that deserves in-depth discussion. According to the characteristics of tinnitus, I started from the theory of brain, mind, and spirit, and focused on the method of strengthening the brain and quieting the mind, and regulating the heart and spirit, and achieved good clinical results.
I. The relationship between tinnitus and the brain, mind, and spirit.
1. The relationship between the ear and the brain and the mind.
Mental activity is a complex series of functional activities carried out by the human brain when reflecting objective things. Emotional and mental changes affect the brain’s stimulation of the information perceived by the auditory and visual senses. Therefore, the normal physiological auditory function is inextricably linked to the healthy state of the brain’s emotional and mental activities, as stated in “Suwen – Pulse to the Essence”, “The head is the house of the essence” and “Medical Primitive”, “The five senses live in the body and are the residence of perception. The ears, eyes, mouth and nose are gathered in the head, the most obvious high things, easy to receive things. The reason why the ears, eyes, mouth and nose into the nearest to the brain, must be the brain first by the visual image and awareness of the, send the, stored.”
2, the relationship between the brain and the mind.
The human spirit, consciousness, sensation, cognitive movement, although in the viscera have their own main, but the most fundamental material basis and control center is in the brain marrow, hearing, vision and mental state of the pathological changes and brain is closely related. For example, in Suwen Linglan Secret Discourse, the interrelationship of the internal organs is proposed by analogy with the ancient imperial official model, and the heart is considered to be the official of the sovereign. Professor Wang Xinlu, after studying the cultural background of the Nei Jing period, pointed out that in the Shuowen Jiezi, “Officials served the ruler”, and the ruler could not be called an official, and in the Five Elements Great Theory, “The chief ruled the official, and the emperor ruled the official”.
According to the rule of officials at that time, the supreme ruler was the Son of Zhou, and all the kings below and in the kingdom were called monarchs, so from this aspect, the monarch was not the supreme ruler at that time, so the heart should not be the master of the five internal organs, let alone the master of the human body. It is also mentioned in the Nei Jing that “if the Lord is not known, the twelve officials are in danger”, from which we can see that the “Lord” should not be included in the “twelve officials”, that is to say The “master” should not be the “heart” but the “brain”.
Therefore, it is further pointed out that the position of the brain in the viscera should be “the brain, the son of heaven, is also the king of the world and command all the officials; the heart is the ruler’s official, from one person and control the ministers; the lungs are the official of the minister, the ruling section out of the ……”, highlighting the position of the brain as the commander-in-chief. With the continuous progress of clinical practice, people have long had a further understanding of the brain. Since the Ming dynasty doctor Li{ realized that the main organism of the soul is not located in the chest of the “flesh and blood of the heart”, in his “Introduction to Medicine – Heart” said: “The heart, the Lord of the whole body, the ruler of the official. There is the heart of flesh and blood, the shape of the lotus flower, living in the lungs and liver; there is the heart of the gods, the gods, the essence of the transformation of blood, and everything by the growth of the color, not coloring the image, that there is what there is, that there is no longer exist, the master of everything, the spirit of emptiness is not unknown. However, the form of God is always the cause.”
He pointed out that there are two “hearts” in the Nei Jing: one is the “heart of flesh and blood” which is hidden in the chest and drives the blood flow, and the official of the sovereign refers to the heart of flesh and blood; the other is the “heart of the gods” which dominates the life activities of the human body. One is the “heart of the gods” that governs the life activities of the human body. Although he does not point out what the “heart of the gods” is, he clarifies that it is never the “heart of flesh and blood” that resides in the chest. Other scholars believe that the “heart of the gods” is the “brain”, such as Li Shizhen of the Ming dynasty, who proposed in his “Compendium of Materia Medica: Xin Yi” that “the brain is the house of the gods”; and Zhang Jiebin of the Ming dynasty, who said in his “Classical Scriptures. Tibetan elephant class” said: “the heart, the sovereign’s official …… wisdom, not by which, it is said that the gods out.”
3, the brain, mind and the relationship between the five will.
Chinese medicine theory, “the heart of the gods”, that is, the brain god, with the main body organs, all the physiological activities of the body and the function of the body’s spiritual consciousness thinking activities. For example, “Su Wen – Ling Lan Secret Discourse” says: “The heart is the official of the sovereign, and the gods come out of it.” The “Ling Shu” says: “The heart is the great master of the five viscera and six bowels, and the house of the spirit.” The “heart of the gods” is also the place where the human emotions and will occur and the master, such as the “class” says: “heart for the five viscera and six bowels of the great master, this is why the five will only heart to make also” “Su Wen – Yin and Yang should be the great treatise” has “people have five Tibetan transformation of five The five qi are used to produce happiness, anger, sadness and fear”. Pathologically, as “Suwen – Linglan Secret Discourse” cloud: “the heart is the ruler of the official …… unclear then the twelve officials dangerous, so that the road is closed and not pass, the shape and great injury. The brain and the five psychological effects on the physiology.
”Sorrow and sadness is the heart, the heart is moving, the five viscera and six internal organs are shaking”, it can be seen that “the heart for the five viscera and six internal organs of the main, and the president of the soul, and comprehensive will, so worry moved in the heart of the lungs should be, thought moved in the heart of the spleen should be, anger moved in the heart of the liver should be, fear moved in the heart of the kidney should be, this is why the five will but the heart to make also “. This is why the heart is the only one responsible for the five wills”. “Although each of the five organs has its own injury, but to find the cause, it is always from the heart. This means that the brain has a controlling and regulating effect on human physiology and psychological emotions.
4. The relationship between tinnitus and the five wills of the brain.
The “five wills”, or “seven emotions”, namely happiness, anger, worry, thought, grief, fear and fright, are typical human emotions. Normal emotional and mental activities can regulate the dirty qi and help to fight against evil, but sudden strong or persistent emotional stimulation and trauma beyond the scope of the body’s ability to regulate, will cause disorders in the internal organs and qi and blood, and qi rebellion will lead to the occurrence of disease. According to Chinese medicine, the five wills arise from the “qi of the five organs”, which is the normal psychology of the human body; at the same time, the changes in the five wills can affect the functions of the five organs, which is an important pathogenic factor in the pathogenesis of the body. In the process of tinnitus, the influence of emotion and will is particularly prominent. According to Chinese medicine, the “seven emotions” such as happiness, anger, sadness, thought, grief, fear and fright can affect the operation of the qi of the internal organs and thus have an impact on the disease.
In the process of occurrence and development of certain diseases, emotions are almost the dominant factor, such as “plum kernel qi”, and also “tinnitus”. For example, “Suwen – six elements of the discipline of the great book” cloud: “wood depression of the hair, …… even then tinnitus vertigo.” This means that depression or irritability causes the liver to lose its control, which turns into fire, and liver yang becomes hyperactive and disturbs the clear orifices, resulting in tinnitus and vertigo; excessive worrying and thinking injures the spleen, resulting in water-dampness not being transported and gathering phlegm, which turns into fire and phlegm fire in the ears, blocking the clear orifices, resulting in tinnitus; excessive thinking causes weakness of the spleen and stomach, which causes the clear yang not to rise and the source of qi and blood to be insufficient, resulting in deficiency of qi and blood, which cannot be served in the ears, leaving the ear orifices empty of meridians. This leads to tinnitus.
The weakness of the spleen and stomach and the failure to raise and lower the qi, prevents the qi of the stomach from moving up the fluid and the turbid yin from dispersing, which fills the nine orifices and prevents the qi of the clear yang from reaching them, causing the five orifices to malfunction. Therefore, “Su Wen – General Commentary on Void and Real” says: “Headache and tinnitus, the nine orifices are unfavorable, and the intestines and stomach are born.” The kidney is the main organ of the kidney and the physiological function of the ear. The ear is the external orifice of the kidney and the official of the kidney, which performs its functions for the kidney: “Liquid off, so the brain marrow eliminates and tibial tinnitus.”
The abnormality of the brain and the five wisdoms is the main cause of tinnitus, such as the “Ling Shu – Hai Lun” says: “If the marrow sea is insufficient, the brain turns to tinnitus…the eyes have no vision”; “Ling Shu – Mouth Question” says: “The brain is dissatisfied, the ears are bitter, the head is bitter, the eyes are dazzling “. The ear is the master of hearing and the division of position perception, and hearing and position perception also belong to the activity of the brain god, and their functions are also produced under the auspices of the brain god. As stated in “Class Jing・Wu Wei Wei Jin Yi Bu”, “The heart is the master of the spirit, so the ears, eyes, lungs, liver, spleen and kidneys are all under the command of the heart, so the hearing of the ears and the sight of the eyes are all under the auspices of the heart”.
Tinnitus is a manifestation of the loss of inner control of the mind. Most of the tinnitus is related to mental and emotional disorders or excessive thought and labor. If the heart and mind are guarded internally, the ears will be clear and tinnitus will not occur; if the heart and mind are not guarded and are restless, the brain and mind will not be at peace and tinnitus will occur. It is also said in “The Complete Book of Ancient and Modern Medicine – Ear Diseases”: “Sadness and contemplation are sad, and heart deficiency and blood depletion will lead to tinnitus and deafness”. Heart deficiency and blood depletion will lead to loss of nourishment of the heart and mind, and if the mind is not guarded internally, tinnitus and deafness can occur.
The occurrence of tinnitus is closely related to the mental and psychological activities of people, and mental and psychological problems can be both the result and the cause of tinnitus. A study by Wang Hongtian et al. found that all 225 cases of subjective tinnitus patients with tinnitus as the first complaint had obvious psychosomatic problems. Among them, tinnitus caused by psychological causes accounted for 21.0%. The psycho-psychological reactions caused by tinnitus accounted for 67.7%, and the indistinguishable sequence (mixed) accounted for 11.3%. The clinical manifestations of depression and neurosis are not only related to psychiatric symptoms. Somatic symptoms are also very common. Somatic discomfort involves all organs and has a variety of manifestations.
Muhlnickel et al [2] suggested that after hearing loss, the alignment of audio localization in all planes of the auditory system changes, functional reorganization occurs, plasticity changes or corticalplasticity occurs in the auditory cortex, and the representative areas of the auditory cortex associated with the frequency of hearing loss gradually decrease, while the adjacent undamaged areas gradually increase. The cortical area associated with the frequency of hearing loss gradually decreases, while the adjacent undamaged area gradually increases. However, cortical sensory-motor areas and subcortical structures remain extensively connected to the function of the undamaged auditory cortex (especially the limbic system) during the later stages of cortical remodeling. Therefore, a serious conflict between pre- and post-remodeling cortical functions occurs, and this conflict is misperceived, i.e., tinnitus is produced.Jastreboff et al [3] proposed a neurophysiological model of tinnitus based on neurophysiological and psychological principles.
Abnormal neuronal activity in the auditory system is first perceived at the lower levels of the auditory system, and this signal is further reinforced by the cortical centers and transmitted to the auditory cortex where it is perceived as a “sound”, i.e., tinnitus. This signal is further reinforced by the cortical centers and is perceived in the auditory cortex as a “sound”, i.e. tinnitus, which is then evaluated by the centers to produce the corresponding loudness and irritability of the tinnitus. Once the abnormal neural activity in the auditory system is detected by the subcortical centers, the cerebral cortex perceives it as an important signal and intensifies the perception and evaluation of it, and then, due to the involvement of the limbic system and the vegetative nervous system, negative perceptions and negative emotions are generated, and the attention to the tinnitus is further intensified, and the changes related to the tinnitus are captured and noticed at any time. The feeling of tinnitus will automatically produce the emotions of tension, irritability, insomnia and fear, and the bad emotional state will again induce the perception of tinnitus, resulting in a vicious circle between tinnitus and bad emotions.
Methods and applications of tinnitus treatment from the brain, mind, and five wisdoms
(1) The treatment of tinnitus is based on the main method of strengthening the brain and quieting the mind.
Because the loss of brain and mind is the main pathogenesis of tinnitus, the treatment of tinnitus should be based on strengthening the brain and quieting the mind. Most of the drugs used in clinical practice are mainly those that return to the brain meridian, and it has been clinically proven that these drugs can exactly adjust the emotional and mental state of the human body. Most of the drugs used in the treatment of tinnitus are heavy in quality or moist in nature, such as dragon bone, dragon tooth, oyster, mother of pearl, cypress seed, sour date, bone crushed tonic, bone fructus, yellow essence, salvia, etc.
Tinnitus is closely related to the brain, mind and soul, and is a manifestation of the loss of internal control of the gods. Clinically, it often manifests as noisy tinnitus, louder tinnitus, insomnia, anxious temperament, tinnitus especially when the heart is troubled, bitterness in the mouth, or sores in the mouth and tongue, yellow and red urine, red tongue tip, yellow moss, and strong pulse. Therefore, if we adopt the method of regulating the mind and treating the heart, so that the heart is calm and the mind is protected internally, the tinnitus can be relieved. The “Yan’s Jisheng Formula” also says: “The six lewd injuries are regulated by the kidneys, and the seven emotions are treated by the heart. The method of medical treatment is to calm the heart and smooth the qi, and if the qi is smooth and the heart is calm, the ears will be clear. Ningxin, that is, to regulate the mind, so that the gods peace within the guard; Qi Shun, that is, the heart cold and heat deficiency calm; Qi Shunxin Ning is the ear God (one of the brain God) clear and quiet within the guard, ear congestion stop.
(B) in the brain Jing Shen treatment at the same time with the adjustment of the heart to regulate the treatment of the corresponding internal organs: such as brain brain to calm the liver and dredge the liver, brain to nourish the heart and calm the mind, brain to strengthen the spleen and open knots, brain to supplement the lungs and benefit the lungs, brain to benefit the kidneys and calm the panic.
1.Brain strengthening and liver relaxation method: It is applicable to tinnitus caused by the seven emotions, liver qi stagnation, qi depression and fire, liver fire disturbing the heart, resulting in heart and liver depression and heat, which disturbs the ear orifice. The symptoms include irritability, impatience, or depression, sullenness, tinnitus aggravated by irritability or poor mood, restlessness at night, stuffiness and distension in the chest, red tongue, thin white or thin yellow moss, and string pulse. Liver harbors the soul, liver in the will is anger, main blood collection, body yin and use of yang, regulating liver will class of Chinese medicine representatives are: Chai Hu bitter, pungent, slightly cold; to the liver, gall bladder meridian. The function can calm the liver and dredge the liver, relieve depression and raise the yang, Yu Jin – pungent, bitter, cold; belongs to the liver, gallbladder and heart meridian. Functions to move qi and relieve depression, cool the blood and clear the heart and calm the liver, “The Materia Medica Preparation” has: “Moves qi, relieves depression, drains blood and breaks up blood stasis. Cools heart heat and disperses liver depression. Peppermint – pungent, cool; belongs to the lung and liver meridians. Function dredges the liver and relieves depression, clearing the head and eyes, “New Compilation of Materia Medica” contains: “Peppermint not only disperses wind, especially to relieve depression, with fragrant herbs to relieve depression, but not as good as the peppermint to relieve depression of more god.” The clinical use of representative prescriptions such as Danmast Prosperity San, etc.
2, brain nourishing the heart and tranquilizing the mind method: applicable to thinking and using the brain, overworking the mind, depleting the heart and blood, deficiency of heart and blood, unable to serve the heart and mind, and tinnitus due to loss of nourishment of the heart and brain. Or tinnitus caused by disorders of the seven emotions or over-excitement, qi depression and fire, heart fire upflammation, disturbance of the brain spirit. Or tinnitus caused by phlegm-heat or phlegm-fire disturbing the heart. Heart blood deficiency is manifested as: tinnitus with small sound, light daytime and nighttime, persistent daytime and nighttime, unpleasant complexion, palpitation, forgetfulness, insomnia and dreaminess, light tongue, thin white moss and weak pulse, etc. Heart fire is manifested as noisy tinnitus, loud tinnitus, heart trouble and insomnia, anxious temperament, tinnitus especially when the heart is troubled, bitter mouth, or mouth and tongue sores, yellow and red urine, red tongue tip, yellow moss, strong pulse, etc.
Phlegm fire disturbing the heart manifests as tinnitus, loud tinnitus, especially at night, irritability and insomnia, bitterness in the mouth, hyperactivity, or coughing up yellow phlegm, dry stool, yellow urine, red tongue or red tongue tip, yellow greasy moss, slippery pulse, etc. The heart harbors the spirit, and the heart is happy in the will. The representatives of herbal medicines for nourishing the heart and will are: Acacia nilotica (Acacia bark) – sweet in taste, flat; belongs to the heart and liver meridians. Can and the heart and the will, dredge the liver to relieve depression, can cure mood disorders, tinnitus due to mental unrest. Fu Shen—Sweet, light, flat; attributed to the heart, spleen and kidney meridians. It can strengthen the spleen, tranquilize the mind and nourish the heart. It is a good medicine for strengthening the spleen and nourishing the middle, treating excessive joy, depleting the heart and blood and abnormal emotions and tinnitus. For those with heart-blood deficiency, it strengthens the brain, nourishes blood and nourishes the heart, calms the mind and quenches tinnitus. Representative prescriptions include Siwu Tang and Sour Jujube Tang with addition and subtraction; for inflammation of the heart fire, to strengthen the brain and clear the heart and calm the mind to quench tinnitus.
For those with phlegm-fire disturbing the heart, strengthening the brain and clearing the heart to resolve phlegm, tranquilizing the mind and quenching tinnitus. Clinical use of representative formulae such as Huanglian Wenzhi Tang, Niuhuang Qingxin Wan.
3.Benefit the brain, strengthen the spleen and open the knot method: Applicable to tinnitus caused by excessive thinking or inappropriate thinking, resulting in depression of spleen and stomach qi, loss of spleen transportation and transformation, deficiency of qi and blood transformation, and loss of nourishment of clear orifices, or tinnitus caused by thinking and injury to the spleen, loss of spleen transportation and transformation, stagnation of dampness and turbidity, and loss of use of clear orifices. The symptoms include tinnitus with a small sound, which is aggravated by thinking and exertion, or when crouching and standing, the head is empty and the ears are weak, the tinnitus is aggravated, the body is tired and weak, the heart is palpitating, forgetfulness, insomnia, poor appetite and stool, the tongue is pale, the moss is thin and white, and the pulse is slow and weak or fine. The spleen harbors the will, and the spleen in the will is thought. Therefore, “thinking hurts the spleen”, which leads to weakness or abnormal transportation and transformation, resulting in insufficient Qi and blood production and loss of nourishment of the clear orifices, resulting in tinnitus. The representative of Chinese herbal medicine to regulate the spleen can be used: Acorus calamus – pungent, bitter, warm; to the heart, spleen, stomach meridian.
It strengthens the spleen, opens the orifices and calms the mind, resolves dampness and harmonizes the stomach. It treats tinnitus caused by worrying about the spleen, loss of spleen health, stagnation of dampness, and loss of use of the clear orifices. Gan Pine – Pungent, sweet, warm; attributed to the spleen and stomach meridians. It is good at opening spleen depression and moving stomach qi, and is an important medicine for awakening the spleen and opening the stomach. It can treat tinnitus due to thought injury to the spleen, loss of spleen transportation, stagnation of dampness, and loss of use of clear orifices.
4.Brain strengthening and lung promotion method: It is used for tinnitus caused by deficiency of lung qi, which does not promote clearness and loss of nourishment of the clear orifices; sadness of lung qi and loss of function of promotion, which can also lead to difficulty in sounding the golden bell and deafness. Or the couples may be loosened, and the external wind may bind the lungs, so that the Qi does not flow smoothly and the ears are not well nourished, resulting in tinnitus, accompanied by nasal congestion, runny nose, a sense of stuffiness in the ears, hearing sounds like a septum, or a cough, and occasionally white phlegm. The lung contains the spirit, and the lung in the will is sadness. Sadness is a negative emotion, mainly manifested by a sad state of mind.
The degree of sadness and grief are different, but they both belong to the lung, and both are emotional reflections of bad stimuli. Excessive sadness and grief can easily lead to astringency and blockage of the qi, which eventually leads to abnormal pronunciation and purification and depletion of the lung qi. The representatives of Chinese herbal medicines for regulating the lung are: Ephedra — pungent, slightly bitter and warm, enters the lung and bladder meridian, promotes the lung, calms asthma, reduces water retention and swelling; Almond — bitter, slightly warm, has a small poison. It belongs to the lung and large intestine meridians.
Promotes the lung to relieve cough and asthma, and also moistens the intestines; ginseng – sweet, slightly bitter, slightly warm, belongs to the heart, lung and spleen meridian. It is a great tonic for the vital energy, tonifies the lung, and calms the mind. Wu Wei Zi – sour, astringent, cold; belongs to the lung, large intestine and kidney meridians. Astringent to the lung, nourishing the kidney and treating tinnitus. For deficiency of lung qi, tonify lung qi, cultivate earth and generate gold, clinically use representative formula such as tonifying lung soup, yi qi smart soup; for loss of lung clearing and purification, evacuate and promote lung qi to open the orifices, clinically use representative formula such as san wu tang, xin yi clear lung drink, etc.
5.Enhancing the brain, benefiting the kidney and calming the nerves: This formula is suitable for tinnitus caused by deficiency of kidney yin, exuberant heart fire, lack of yin and yang, water and fire imbalance, and lack of intercourse between the heart and kidney. It is often manifested as tinnitus that is more severe and does not heal after a long time, or hearing loss, long-term insomnia, dry mouth and tongue, soreness and weakness of the waist and knees, feverishness of the five hearts, dreaming and seminal emission, dizziness and headache, short red and astringent urine, red tongue with little moss and fine pulse; or tinnitus caused by deficiency of the body or long-term disease that injures the kidneys, or state of love and desire that depletes the kidney essence, or the body in advanced age that has been depleted of heavenly sap, deficiency of kidney essence, emptiness of the medulla, and loss of warmth in the ear orifice. The symptoms are cicada-like sounds in the ears, light day and heavy night, dizziness and forgetfulness, soreness and weakness of the waist and knees, fear of cold extremities, frequent urination at night, pale tongue, white fur, and sunken pulse; or tinnitus caused by fright and fear and over-excitation of the seven emotions, resulting in lack of vigilance and restlessness of the mind and spirit.
It is characterized by palpitations, restlessness, insomnia, tinnitus, noisy tinnitus, nighttime sleepiness, chest fever, red tongue with yellow fur, and string or knotted pulse. The kidneys collect the will, and the kidneys are afraid in the will. The main manifestation of fear is nervousness and horror, which is a passive emotion. Fear, timid and intimidated as the main performance, is a passive emotion. Fear is excessive fear, fear is a sudden frightened a mental stimulus, the difference is that fear is self-knowledge and fear is not self-knowledge, both are bad stimulus, can make the body’s qi run disorder or kidney gas uptake without the right, while the big fright and fear will hurt the heart and mind, so there is also a heart Zhi said. When fear is excessive, the essence of the kidney cannot be carried upward, and the clear orifices are not nourished, then the ears will ring. Commonly used drugs to calm the kidney are: magnet – salty, cold; belongs to the heart, liver and kidney meridians. It can be used to treat tinnitus caused by kidney deficiency, liver depression, liver fire, disturbance of the heart and mind, or panic and qi disorder.
The herbal derivative “contains”: “nourishing benefit kidney energy, fill the essence, kidney deficiency deafness and dizziness are used.” Ba Ji Tian – sweet, pungent, slightly warm; belongs to the kidney and liver meridians. Can nourish kidney yang, benefit essence and blood, strengthen tendons and bones, can treat frightening injury to the kidney, kidney deficiency tinnitus. Xian Ling Spleen – Pungent, sweet, warm. Giving rise to the liver and kidney meridians , used for kidney deficiency and yang failure, tinnitus, impotence and weakness of the waist and knees. For deficiency of kidney yin and non-interaction between the heart and kidney, representative formulae such as Huang Lian A Gao Tang and Jiaotai Wan are used clinically; for deficiency of kidney essence and loss of warmth in the ear, representative formulae such as Zuo Ci Wan for deafness and Jin Kui Kidney Qi Wan are used clinically; for tinnitus due to disturbance of the heart and mind caused by panic, representative formulae such as Zhu Sha An Shen Wan and Magnetic Zhu Wan are used clinically, or Amber An Shen Wan (Amber, Xuan Shen, Tian Men Dong, Dan Shen, Angelica Sinensis, Ginseng, Poria, Jujube, Licorice, Radix et Rhizoma. The formula is also used to reduce the number of cases of amber tranquilizer pills (amber, xuan shen, tianmen dong, dan shen, angelica, ginseng, poria, jujube, licorice, cypress seed, wu wei zi, sour date, far zhi, he hua huan, orris).