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SENILE DEMENTIA/SENILITY

GENERAL

Clinical Manifestations	Rule Out: Depression Other psychiatric problems Sensory loss Metabolic and endocrine disturbances Bladder and bowel disorders Nutritional deficiencies Trauma Tumor Infections Cardiovascular or cerebrovascular accidents
Treatment Principle
Herb Formulas
Points

WIND-COLD DAMPNESS WITH BLOOD AND PHLEGM STAGNATION

Clinical Manifestations	Chronic pain, weakness and numbness (especially in the lower extremities) due to Windstroke Muscle spasms Cramps Heaviness and pain in the lower back and legs Fixed or migrating pain in the bones in the bones and joints with reduced range of motion Long-term numbness or paralysis in the hands and feet T: Normal C: White and moist
Treatment Principle	Dispel Wind Eliminate Dampness Transform Phlegm Invigorate the Blood Unblock the collaterals Alleviate pain Warm the channels and collaterals
Herb Formulas	Wu Yao Shun Qi San
Points	General points

LUNG AND KIDNEY YIN DEFICIENCY

Clinical Manifestations	Unproductive cough or Scanty, sticky phlegm or Sometimes blood-streaked sputum Dry mouth Dry throat Low back and knees sore and weak "Steaming Bone" tidal fever Night sweats Malar flush Maybe hoarse voice Maybe pain in shin, foot, and heel Sterility Spermatorrhea T: Red and dry C: None P: Thready and rapid
Treatment Principle	Nourish Yin Moisten the Lungs Reinforce the Kidneys
Herb Formulas	Ba Xian Chang Shou Wan Mai Wei Di Huang Wan
Points	HT-6, KI-3, KI-6, LU-6, LU-9, UB-13, UB-23

PHLEGM-FIRE DISTURBS THE HEART

Clinical Manifestations	Irritability Palpitations Bitter taste in mouth Insomnia Much dreaming Dizziness Easily startled Restlessness A stuffy feeling in the chest T: Red tip C: Yellow and greasy P: Slippery, Excess, rapid and maybe wiry
Treatment Principle	Clear the Heart Break through Phlegm
Herb Formulas	Wen Dan Tang Dang Tan Tang
Points	Bleed the Jing-Well points of the six Hand channels, Anmian, Dingshen, DU-14, DU-16, DU-20, DU-26, HT-7, PC-5, PC-6, PC-7, PC-8, REN-14, SP-1, ST-40, UB-15

HEART AND KIDNEY YIN DEFICIENCY

Clinical Manifestations	Insomnia with much dreaming Spermatorrhea with erotic dreams Premature ejaculation Irritability Easily startled Palpitations Poor memory Dizziness Tinnitus Low back soreness Legs weak Tidal fever Night sweats Dry mouth Red cheeks Urine short and red T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Reduce Fire Make Heart and Kidney communicate
Herb Formulas	Jiao Tai Wan Tian Wang Bu Xin Dan Liu Wei Di Huang Wan Mai Wei Di Huang Wan With Fire Rising: Dao Chi San
Points	HT-7, KI-3, PC-6, PC-7, UB-15, UB-23

LIVER QI STAGNATION INVADING THE SPLEEN

Clinical Manifestations	Abdominal distention and pain Gas Borborygmus Diarrhea Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger Women: Irregular menses Dysmenorrhea Breast distention and pain before and during menses T: Pink C: White and greasy P: Slippery and wiry
Treatment Principle	Soothe the Liver Invigorate the Spleen
Herb Formulas	Dang Gui Shao Yao San
Points	LIV-3, LIV-13, SP-6, ST-25, ST-36, ST-37

LIVER YANG RISING

Clinical Manifestations	Insidious onset Memory loss without inattentiveness and depression (early stage) Loss of computational ability Word-find and concentration problems Difficulty with ordinary activities such as dressing, cooking, balancing the checkbook Severe memory loss (later stage) Complete disorientation (late stage) Social withdrawal (late stage)
Treatment Principle	Calm Liver Yang
Herb Formulas	Zhi Bai Di Huang Wan
Points	Group 1: DU-15, PC-8, ST-36, UB-23 Group 2: DU-14, REN-15, SP-6, KI-1 Group 3: DU-15, Shixuan, LI-10, KI-3 Use the three groups alternately day for 1 minutes for three days. Rest 5-7 days. Repeat Moxibustion: Use ginger and 3-5 moxa cones every other day on the above points for ten treatments. Rest 5 days and repeat as needed

LIVER AND KIDNEY YIN DEFICIENCY

Clinical Manifestations	Dementia Facial complexion pale and sallow Both cheeks slightly red Dizziness Dry eyes Blurred vision Spots before the eyes Numbness of limbs Flaccid paralysis (Wei syndrome) Tremors Paralysis Weakness Forgetfulness Low back and knees sore and painful Throat dry and painful Five sole Heat	Low-grade fever Night sweats Tinnitus Deafness Irritability Suspiciousness Insomnia Stools difficult to pass Constipation Men: Spermatorrhea Women: Irregular menses or Scanty menses or Amenorrhea Vaginal discharge T: Red C: None P: Thready and rapid
Treatment Principle	Nourish and reinforce the Kidneys and Liver
Herb Formulas	Qi Ju Di Huang Wan Zuo Gui Wan modified Mai Wei Di Huang Wan Chinese Patent Medicines: Hui Tian Zai Zao Wan
Points	Group 1: DU-15, PC-8, ST-36, UB-23 Group 2: DU-14, REN-15, SP-6, KI-1 Group 3: DU-15, Shixuan, LI-10, KI-3 Use the three groups alternately day for 1 minutes for three days. Rest 5-7 days. Repeat Moxibustion: Use ginger and 3-5 moxa cones every other day on the above points for ten treatments. Rest 5 days and repeat as needed

KIDNEY YANG DEFICIENCY

Clinical Manifestations	Memory loss Lumbago: low back feels cold, weak and aching Feeling chilled Aversion to Cold Cold limbs General debility Pale face Urinary frequency with abundant, clear urine or Oliguria with edema Maybe nocturia Lassitude Dizziness Tinnitus	Withdrawn, subdued behavior Knees feel cold and aching Impotence, spermatorrhea, premature ejaculation Low libido Female infertility (“uterus cold and infertile”) Maybe anorexia Maybe loose stools Maybe chronic diarrhea or “cock crow” diarrhea T: Pale and swollen C: Thin and white P: Deep and thready - maybe slow
Treatment Principle	Tonify the Kidneys Tonify Yang
Herb Formulas	Jin Gui Shen Qi Wan
Points	Moxa UB-23, DU-4, KI-3, KI-7

KIDNEY YIN DEFICIENCY

Clinical Manifestations	Dizziness Tinnitus or deafness Poor memory Aching, soreness or weakness of low back Spermatorrhea or premature ejaculation Aching in bones Aching in leg and heel * Dry mouth * Thirst * Night sweats * Five sole heat * Malar flush * Low grade fever in the afternoon * Dry throat, maybe recurrent sore throat * Dry stools and / or constipation * Urine short and red * Heightened libido T: Red C: Little or None P: Thready and rapid All signs and symptoms marked with an asterisk () are due to Deficiency Fire
Treatment Principle	Nourish Yin Reinforce the Kidneys
Herb Formulas	Liu Wei Di Huang Wan Mai Wei Di Huang Wan
Points	KI-1, KI-3, KI-6, REN-4, SP-6, UB-23

KIDNEY YIN DEFICIENCY WITH FIRE RISING

Clinical Manifestations	Dizziness Tinnitus or deafness Poor memory Aching, soreness or weakness of the low back Spermatorrhea or Premature ejaculation Aching in the bones Aching in the leg and heel Dry mouth Thirst Night sweats Five sole Heat Malar flush Low grade fever in the afternoon Dry throat, maybe recurrent sore throat Dry stools and/or Constipation Urine short and red Heightened libido If Heart Fire also Flares: Insomnia Frequent dreams Palpitations If Liver Yang also Rises: Dizziness Blurred vision T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Subdue Fire
Herb Formulas	Zhi Bai Di Huang Wan
Points	KI-1, KI-2, KI-3, KI-6, KI-9, KI-10, REN-4, SP-6, UB-23 If Heart Fire also Flares: HT-7, PC-7, UB-15 If Liver Yang also Rises: LIV-3, UB-18

KIDNEY JING DEFICIENCY

Clinical Manifestations	Memory loss Severe cases: Loss of recognition of close relations Forgetting events instantly Dulled sensation Generalized weakness Dizziness Tinnitus Low back and knees weak and aching Hair loss Graying or whitening of hair Dull, lifeless hair Weak sexual function Impotence Infertility Atrophy and weakness of feet with difficulty walking Senility (premature or mature) Brittle bones Gradual deterioration of hearing Emaciation Frequent urination Nocturia Loss of visual acuity T: Pale C: Thin and white P: Thready and weak
Treatment Principle	Nourishes Yin Tonifies the Kidneys Nourish Jing
Herb Formulas	Zuo Gui Wan You Gui Wan Ren Shen Yang Rong Tang Chinese Patent Medicines: Gui Ling Ji Ge Jie Da Bu Wan Ren Shen Lu Rong Wan Gui Lu Er Xian Jian
Points	UB-23, UB-15, Moxa UB-11, DU-4, REN-4, HT-7, KI-3 UB-23, moxa UB-11, REN-4, DU-4, ST-36, GB-34 DU-4, DU-20, HT-7, KI-1, KI-3, KI-6, SI-3, UB-15, UB-23, UB-52, UB-62

KIDNEY AND SPLEEN YANG DEFICIENCY

Clinical Manifestations	Dementia Dull Spirit Taciturnity Aphasia Anorexia Aversion to Cold Body cold Limbs icy Complexion white and shiny Low back, knees and abdomen feel cold and painful Lower abdomen feels cold and painful Loose stools containing undigested food “Cock-crow” diarrhea (occurs at about 5 am) Maybe urinary and/or fecal incontinence Edema of face and limbs Tinnitus Deafness Dysuria Abdominal ascites Paralysis T: Pale, moist and swollen C: Thin and white or White and greasy P: Deep, thready, weak and maybe slow
Treatment Principle	Warm and Reinforce the Spleen and Kidneys
Herb Formulas	Fu Gui Li Zhong Tang Jin Gui Shen Qi Wan modified With aphasia and coma: Di Huang Yin Zi modified
Points	Moxa or moxa needle REN-4, REN-12, SP-6, SP-9, ST-36, UB-20, UB-23

QI DEFICIENCY WITH BLOOD STASIS

Clinical Manifestations	Insidious onset Memory loss without inattentiveness and depression (early stage) Loss of computational ability Word-find and concentration problems Difficulty with ordinary activities such as dressing, cooking and balancing the checkbook Severe memory loss (later stage) Complete disorientation (late stage) Social withdrawal (late stage)
Treatment Principle	Strengthen Qi Activate Blood
Herb Formulas
Points	Group 1: DU-15, PC-8, ST-36, UB-23 Group 2: DU-14, REN-15, SP-6, KI-1 Group 3: DU-15, Shixuan, LI-10, KI-3 Use the three groups alternately day for 1 minutes for three days. Rest 5-7 days. Repeat Moxibustion: Use ginger and 3-5 moxa cones every other day on the above points for ten treatments. Rest 5 days and repeat as needed

BLOOD STAGNATION OBSTRUCTS THE CHANNELS

Clinical Manifestations	Dementia Persistent, inappropriate behavior Mechanical, repetitive actions, body postures and/or speech patterns Insomnia Poor memory Headache Vertigo Deafness Aphasia Tremors Hemiplegia T: Dark with stagnant spots C: Normal P: Hesitant
Treatment Principle	Tonify and invigorates the Blood Regulate Blood circulation Break up Blood Stagnation
Herb Formulas	Tao Hong Si Wu Tang
Points

BLOOD AND PHLEGM STAGNATION

Clinical Manifestations	Forgetfulness Poor memory Absent mindedness Short attention span Inability to concentrate Slow speech Dull senses A blank expression T: Dark or pale purple with echymoses and dark sublingual veins C: Greasy and white P: Slippery and choppy or Thready and choppy
Treatment Principle	Transform Phlegm Invigorate the Blood Eliminate Stasis
Herb Formulas	Shou Xing Wan Chinese Patent Medicines: Fu Fang Dan Shen Pian Sheng Tian Pian Jing Gu Du Sheng Wan Fu Ke Wu Jiao Wan
Points	DU-20, LI-4, PC-4, Sishencong, SP-3, SP-6, ST-40, UB-15, UB-17, UB-23, UB-52

TURBID PHLEGM BLOCKING THE ORIFICES

Clinical Manifestations	Dull appearance Dementia Slow response Poor memory Muttering to oneself Stuffy chest Anorexia Excessive, sticky salivation T: Pale C: Sticky and white P: Soft and slippery
Treatment Principle	Resolve Phlegm Open the Orifices
Herb Formulas	Dementia #1
Points

WIND-PHLEGM (FENG TAN) WITH QI AND YIN DEFICIENCY

Clinical Manifestations	Marked emotional changes and behavior Irritability A feeling of Qi rushing upward Red eyes Headache - lasts all day Palpitations Tinnitus A feeling of distention and oppression below the Heart Abdominal bloating Muscle spasms in the shoulders, neck and back Dizziness Vertigo Insomnia Hot flushes Anorexia Paralysis Numbness Slurred speech Deviated eyes Deviated mouth (wry mouth) Sputum in the throat Chest fullness and distention Epigastric fullness and distention Hypertension Stroke T: Deviated and trembling, maybe red edges C: Thick or Greasy P: Slippery and maybe wiry or Soft and wiry and maybe rapid
Treatment Principle	Resolve Phlegm Subdue Wind
Herb Formulas	Gou Ten San
Points

PHLEGM-HEAT

Clinical Manifestations	Dementia Stubborn behavior Irritability Red face and eyes Poor memory Insomnia Excessive flow of saliva T: Red C: Yellow and sticky P: Wiry, slippery and rapid
Treatment Principle	Clear Heat from the Heart Resolve Phlegm
Herb Formulas	Wen Dan Tangmodified
Points	LI-11, LU-5, ST-40, UB-13