Manic Depressive Psychosis TCM Diagnoses and Treatments Within

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Manic & Depressive Psychosis TCM Diagnoses and Treatments Within TCM there are two main

Manic & Depressive Psychosis TCM Diagnoses and Treatments Within TCM there are two main types of strong psychological disorders: Dian - yin type which is associated withdrawal, passivity and antisocial behavior, generally considered more chronic. Kuang - yang type which is associated with aggressivity, movement and violence, generally consider more acute. Within modern medicine there are various mental disease, including organic & functional psychoses ( bipolar disorder, obsessive-compulsive, or paranoid schizophrenic) Etiology & Pathology: 1. Imbalance of Yin & Yang: 2. Seven emotional hyperactivity 3. Phlegm 4. Pathogenic fire 5. Blood & Qi stag.

Main Points for differentiation A) Location of the disease Liv. GB. Kid. Heart B)

Main Points for differentiation A) Location of the disease Liv. GB. Kid. Heart B) Depressive (Dian) & manic Syn. (kuang) Depressive Manic Syn. Sym. Mental depression, reticence, dementia, being slow moving Racketing, maltreatment, mania, unease & hyperactive behaviors Initial Mostly def. Excess Etiology Phlegm block Qi; Ht. & Sp Def. Phlegm & Fire Treatmen t Regulating Qi, Relieving stag. , Nourishing Ht. & Sp. , Enriching blood, Tranquilizing mind Eliminating pathogenic factors (Purging fire; Reducing phlegm; Nourishing Yin & reducing fire) Herbs Drastic herbs

Blood Provides the material foundation for the mind & spirit “ Blood is the

Blood Provides the material foundation for the mind & spirit “ Blood is the mind of a person” “ When blood is harmonized, the mind has a residence” Ht. – Housing the mind, Governing Blood vessels Liv. – Housing the Ethereal soul , Storing the blood Any emotional stress -- Ht. or liv. - Ht. blood or Liv. Blood -> mind or soul Blood was effected by emotional problems in 3 ways Def. Ht. blood def. : Feel depressed & tired; mind maybe confused & lack concentration liv. Blood def. : may lack a sense of direction in life & “vision” Stag. Ht. blood stag. : restless & prone to be easily startled Liv. Blood stag. : very anxious, restless and confused about his or her aims of life Heat Ht. heat: extremely anxious & agitated; impulsive & restless Liv. Heat: violent & hit people, feel angry & frustrated about his life, tend to be impulsive

Treatment Depressive Psychosis 1). Qi Stag. Combined with phlegm Signs & Symptoms: – Main

Treatment Depressive Psychosis 1). Qi Stag. Combined with phlegm Signs & Symptoms: – Main Sym. : mental depression, apathetic depression, reticent, dull-witted (dementia), or suspicious & over-anxious, subjecting to changing mood, speaking incoherently • – Concurrent sym. : muttering to oneself, subjecting to changing mood, loose of appetite – Tongue: light tongue proper, whitish & greasy fur – Pulse: wiry & slippery Treatment Protocol: – Soothing stag. liver Qi – Resolving phlegm

Formula: Tao Tang Ban Xiao Dan Nan Xing Chen Pi Zhi Shi Fu Ling

Formula: Tao Tang Ban Xiao Dan Nan Xing Chen Pi Zhi Shi Fu Ling Ren Shi Chang Pu Zu Ru Gan Cao Shen Jiang Modifications: Xiao Yao Powder Soothing Liver Qi -- Xiang Fu, Yu Jin Mental disorder -- Su He Xiang Wan Accumulation of phlegm in chest & diaphragm -- San Sheng San ( Gua Di, Fang Feng, Li Ru) Associated with sleeplessness & being subjecting to frightening, dysphoria & unconsciousness, yellow greasy fur -- Wen Dan Tang + Zhi Bao Wan Frequent belching & feeling of oppression in chest and abdomen -- Xuan Fu Hua, Dai Zhe Shi, Zi Su Geng

Treatment Depressive Psychosis 2). Qi Def. & phlegm accumulation Signs & Symptoms: – Main

Treatment Depressive Psychosis 2). Qi Def. & phlegm accumulation Signs & Symptoms: – Main Sym. : Apathetic & indifferent expression, reticent even transfixed, staring like a fool, thinking aloud, lack of initiative, confused mind, presumption, reckless action, blame oneself. • – Concurrent sym. : sallow complexion, loose stool, clear urine – Tongue: light & enlarged body, whitish & greasy fur – Pulse: slippery & weak Treatment Protocol: – – Tonify Qi Nourish Spleen Eliminating phlegm Calm down the mind

Formula: Tao Tang Ban Xiao Dan Nan Xing Chen Pi Zhi Shi Fu Ling

Formula: Tao Tang Ban Xiao Dan Nan Xing Chen Pi Zhi Shi Fu Ling Ren Shi Chang Pu Zu Ru Gan Cao Shen Jiang Si Jun Zi Tang Modifications: Soothing Liver Qi, & open mind -- Yuan Zhi, Yu Jin Severe perplexed and dull-witted state -- Su He Xiang Wan

Treatment Depressive Psychosis 3) Heart & Spleen Def. Signs & Symptoms: – Main Sym.

Treatment Depressive Psychosis 3) Heart & Spleen Def. Signs & Symptoms: – Main Sym. : protracted course of disease, the illness developed slowly, pale complexion, sluggish, too lazy to speak, listlessness, absentminded, palpitating, susceptible to fright and sorrow, presumption, disturbance of thought, talk in a confused manner, demoralized – Concurrent sym. : dreaminess, loss of appetite, loose stool. – Tongue: enlarged body with teeth marks – Pulse: weak • Treatment Protocol: – Nourish Spleen & heart – Calming mind

Formula: Yang Xin Tang Ren Shen Huang Qi Gan Cao Fu Ling Fu Shen

Formula: Yang Xin Tang Ren Shen Huang Qi Gan Cao Fu Ling Fu Shen Dang Gui Chuan Xiong Ban Xia Po Zi Ren Suan Zhao ren Yuan Zhi Wu Wei Zi Modifications: Kidney Yang Def. -- Ba Ji Tian, Rou Cong rong, Bu Gu Zhi Palpitation & fright -- Ci Shi, Long Chi Grief with susceptibility to weeping -- Zhi Gan Cao, Huai Xiao Mai

Treatment Manic Psychosis 4) Phlegm-fire disturbing heart Signs & Symptoms: – Main Sym. :

Treatment Manic Psychosis 4) Phlegm-fire disturbing heart Signs & Symptoms: – Main Sym. : Onset suddenly, impetuousness, headache, sleeplessness, staring angrily, flushed face & ears, suddenly mad and violent rage, enthusiasm running high, speaking disorderly, climbing walls & roofs, abnormally powerful, making racket & shout in confusion, not caring about various relations, or destroying things & harming others persons, loving cold drinks, constipation, dark urine – Concurrent sym. : day & night without sleep and eating – Tongue: deep red body, yellow and greasy fur – Pulse: wiry slippery, rapid and forceful • Treatment Protocol: – Purging fire – Eliminating phlegm – Calm down mind

Formula: Xie Xing Tang Da Huang Qin Huang Lian Meng Shi Gun Tan Wan

Formula: Xie Xing Tang Da Huang Qin Huang Lian Meng Shi Gun Tan Wan Modifications: Nourish Yin & clear away fire -- Zhi Mu Calm down mind -- Iron Yang Ming Sym. + constipation -- Da Chen Qi Tang Restlessness & thirsty with desire to drink -- Mang Xiao 5 g Restlessness & insomnia due to phlegm heat -- Huang lian, Zhu Ru, Zhi Shi

Treatment 5) Hyperactivity of fire due to yin Def. Signs & Symptoms: – Main

Treatment 5) Hyperactivity of fire due to yin Def. Signs & Symptoms: – Main Sym. : illness condition alleviated after protracted manic psychosis, be weary in mind, emotional instability, nervous, impatient, palpitating, be susceptible to fright, sometimes mad, restlessness, sleeplessness, feverish sensation in chest, palm & sole – Concurrent sym. : thin body shape, scanty dark urine, constipation – Tongue: red body, less or no fur – Pulse: thready rapid or wiry rapid • Treatment Protocol: – Nourish Yin & removing fire – Tranquilizes the mind

Formula: An Shen ding Zhi Wan Fu Ling Fu shen Yuan zhi Shi chang

Formula: An Shen ding Zhi Wan Fu Ling Fu shen Yuan zhi Shi chang pu Ren shen Long Chi Modifications: Nourish Yin: -- Er Yin Jian ( Shen di, Mai dong, Xuan shen) Clear the fire -- Bai Wei, Di Gu Pi Calm down mind -- Fu Shen, Suan Zhao Ren, Gan Cao Amnesia, sore lower back and weak knees, -- Gui Ban, Gou Qi Zi, E Jiao

Treatment Manic Psychosis 6) Blood & Qi Stag. Signs & Symptoms: – Main Sym.

Treatment Manic Psychosis 6) Blood & Qi Stag. Signs & Symptoms: – Main Sym. : dysphoria, fury, talk much, even singing, running & taking off clothing, or dumbstruck, talk less, being in a confused state of mind, often with darkish complexion, stabbing pain and fullness feeling in chest & hypochondrium, palpitating. . Or abdominal pain during the menstrual period in women, dark and clot in menstruation, or having injuries from falls, fractures, contusions and strains. – Concurrent sym. : headache or feeling fullness in the head – Tongue: dark purple body, thin whitish or thin yellow fur – Pulse: wiry thready or deep wiry • Treatment Protocol: – Promoting blood circulation & removing blood stasis – Activating the flow of Qi

Formula: Dian Kuang Meng Xing Tao Ren Cai Hu Xiang Fu Mu Tong Chi

Formula: Dian Kuang Meng Xing Tao Ren Cai Hu Xiang Fu Mu Tong Chi Shao Ban Xia Da Fu Pi Qin Pi Chen Pi Sang Bai Pi Su Zhi Gan cao Da Huang Zhe Chong Wan Modifications: fever due to blood stasis -- Huang Qin Cold sym -- Gan Jiang, Fu Zi Calm down mind -- Fu Shen, Suan Zhao Ren, Gan Cao Dry & bitter mouth with yellow greasy coating -- Huang Qin Dark purplish tongue body -- Dan Shen, Hong Hua

 • Other treatments Dan Shen 60 g, Ye Jiao Teng 30 g, Ling

• Other treatments Dan Shen 60 g, Ye Jiao Teng 30 g, Ling Zhi 10 g, Da Zao 10 pcs ( Applicable to various types of schizophrenia) Gan Sui 10 g, Da Ji 10 g, Da Huang 10 g, Bai Jie Zi 10 g, Ai Ye 10 g, Shi Chang Pu 10 g ( Applicable to various types of schizophrenia )

Case History 1. Female 45 years Medical history: Usually narrow-minded, oversensitive, over anxious, feeling

Case History 1. Female 45 years Medical history: Usually narrow-minded, oversensitive, over anxious, feeling incompatibility between she and her husband. Her husband stayed at other places for a long period of time, and suspected that she has unfaithful intentions after back home and later beat her. Once after vigorous quarrel, she suddenly look steadily, reticent, refuse to take food and drink, then shouting at top of her voice, climbing walls and getting on roofs, being subject to changing mood, taking off her clothes in the presence of all, hitting others and destroying things; 3 or 4 young men could not check her. First visiting: Main complain: Manic Psychosis ears, Most of the above symptoms had alleviated. Her symptoms manifested as flushed face and constipation Tongue: red tongue with yellow fur Pulse: TCM diagnose: Phlegm-fire disturbing mental activities Treatment protocol: -- Eliminating phlegm --Clear the fire --Tranquilize the mind Formula: Meng Shi Gun Tan Wan + Dan Zhi Xiao Yao Wan

Case History 1. Male 31 years Medical history: First visiting: Main complain: Bipolar disorder

Case History 1. Male 31 years Medical history: First visiting: Main complain: Bipolar disorder for 3 years Patient was treated by western medicine for 3 years, however, symptoms were still unstable. 3 month ago, patient’s mental status started to be unstable again. Deliria. Thought himself should be a top leader of a big company. Be proud of his manage ability. Feel excited, irritability, insomnia, headache, distension feeling of head good appetite Tongue: dark red body with purple spot, yellow fur Pulse: wiry TCM diagnose: Blood stasis insulting mind Liver Qi stag. Treatment protocol: --Promoting blood circulation -- Smoothing Liver Qi --Tranquilize the mind Formula: Cai Hu 12, Xiang Fu 12, Qin Pi 10, Su Zi 15, Zheng Zhu Mu 30, Tao ren 15, Hong Hua 15, Chi Shao 20, Yu Jin 15, Da Huang 15, Long Gu 30, San Ling 15, E Zhu 15, Suan Zao Ren 15

Epilepsy TCM Diagnoses and Treatments Suddenly falling on the ground, unconsciousness, spitting saliva, staring

Epilepsy TCM Diagnoses and Treatments Suddenly falling on the ground, unconsciousness, spitting saliva, staring upwards, clonic convulsion, or shouting as bleat or pig yell, and regaining consciousness some time later Etiology & Pathology: 1. Mental disorder 2. Congenital factors 3. Miscellaneous

Main Points for differentiation A) Def. or Excess: Wind-phlegm Internal phlegm-fire Internal blockage of

Main Points for differentiation A) Def. or Excess: Wind-phlegm Internal phlegm-fire Internal blockage of blood stasis Def. Heart & Kidney def. Liver & kid. Yin def. B) Attacking & Remission period Attacking: eliminating phlegm & regulating Qi Remission: Tonify the liver & kid. Yin C) Yang type & Yin Type Yang Type: Syndrome of excess heat Yin Type: Syndrome of deficient cold

Yang Type Yin type Good constitution Constitution is not very good, Vital Qi is

Yang Type Yin type Good constitution Constitution is not very good, Vital Qi is gradually exhausted Sudden attack, falling down & shout, clonic convulsion & spitting, lockjaw, looking upwards with taut, Suffered from frequent attack of epilepsy, pale complexion, dullwitted, unconsciousness, reticent, dumb-struck Rapid or wiry slippery Deep, wiry or deep & slippery

Principles of the treatment Treatment must be according to the stage of the disease:

Principles of the treatment Treatment must be according to the stage of the disease: Attacking or Intervals