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DELIRIUM

GENERAL

Clinical Manifestations	Rapid onset Inattention Rambling Irrelevant or incoherent speech Difficulty staying awake during exam Perceptual disturbances (misinterpretations, illusions or hallucinations) Insomnia Daytime sleepiness Increased or decreased psychomotor activity Disorientation (time, place or person) Memory impairment (inability to learn new material or remember past events) Evidence of specific organic factors Etiologically related to the disturbance or Ruling out of any non-organic mental disorder Fluctuation in the course of the disease Most commonly occurs in those over eighty with pre-existing cognitive impairment
Treatment Principle
Herb Formulas
Points

TAI YANG SHANG HAN WITH INTERNAL HEAT

Clinical Manifestations	Fever and chills Maybe fever only Achiness Anhidrosis Occipital headache Loud cough Sticky, yellow mucus Sore throat Generalized muscle aches Nasal obstruction Asthma Aversion to Cold Edema Thirst with a desire for cold liquids Restlessness Irritability Fidgeting Constipation or Dry stools Sometimes dry achy eyes T: Normal or red or Red tip C: Yellow or white P: Floating and tight or Floating and rapid
Treatment Principle	Expel Wind Disperse Cold Cool Heat
Herb Formulas	Shi Gao Tang
Points	DU-14, DU-16, GB-20, LI-4, LI-11, ST-44, UB-13, sedate LU-7, LU-9, LU-10, SJ-5, UB-12, tonify SP-1, SP-2 Dingchuan, DU-14, LI-4, LI-11, LU-5, REN-17, SJ-5, UB-12 For a severe, swollen, sore throat: + LU-11, SI-17 With Excess Internal Heat: + LU-10, SJ-2

WEN BING: YING STAGE HEAT ATTACKS THE PERICARDIUM

Clinical Manifestations	High fever worse at night Thirst Insomnia Major mental problems Dramatic change of personality Delirium Speech difficulty Aphasia Poor memory Dizziness Maybe fainting Maybe coma Feverish extremities T: Deep red P: Thready and rapid
Treatment Principle	Clear Heat in Pericardium
Herb Formulas	An Gong Niu Huang Wan Zi Xue Dan Niu Huang Qing Xin Wan
Points	To Clear Heat from the Heart: HT-3, PC-8, Sifeng, bleed Shixuan For delirium: PC-7 To detoxify: LI-11 To Pacify Heart and calm the Shen: HT-5, HT-6, HT-7 To Nourish Yin: KI-3, SP-6

PHLEGM OBSTRUCTS THE HEART ORIFICE: TENSE TYPE YANG OBSTRUCTION

Clinical Manifestations	Sudden collapse with loss of consciousness Lockjaw (trismus) Eyes open Both fists clenched Retention of urine Constipation Stiffness and spasm of limbs Red face Body feels hot Coarse breathing Bad breath Restlessness Involuntary movements Usual sequelae of C.V.A. such as: Hemiplegia Aphasia Facial paralysis T: Pink C: Yellow and greasy P: Slippery, wiry and rapid
Treatment Principle	Clear Phlegm Open the Orifices
Herb Formulas	(Ju Fang) Zhi Bao Dan An Gong Niu Huang Wan Ling (Yang) Jiao Gou Teng Tang modified
Points	Bleed the Jing-Well points of the Six Hand channels, needle DU-20, DU-26, KI-1, LIV-3, ST-40

LIVER FIRE

Clinical Manifestations	Severe, splitting headaches with dizziness Sudden tinnitus or Sudden deafness Flushed face Red, swollen, painful eyes Irascibility with violent angry outbursts Dry mouth Bitter taste in mouth Thirst Vomiting sour or bitter liquid Insomnia Restlessness Constipation or dry stools Maybe rib pain In severe cases: Mania Hemoptysis Hematemesis Epistaxis Liver Fire Attacks the Lungs: Hemoptysis Rib pain which is severe when coughing Liver Fire Attacks the Stomach: Hematemesis T: Red tip and edges C: Thick, yellow, dry and rough P: Wiry, Excess and rapid
Treatment Principle	Clear the Liver Purge Fire
Herb Formulas	Long Dan Xie Gan Tang
Points	GB-12, GB-34, GB-37, LIV-2, UB-18, UB-19

TOXIC HEAT WITH PHLEGM RETENTION

Clinical Manifestations	Distending full painful sensation in the Stomach and Intestines Vomiting Diarrhea Swelling Chest and hypochondriac pain Inability to swallow even fluid Pinkish vomit Dull complexion Weight loss Dry skin Dry mouth and throat Constipation Stools like pebbles Violent cramping abdominal pain Nausea Tenesmus Restlessness Mental confusion bordering on delirium
Treatment Principle	Transform Phlegm Open the Orifices Clear Toxicity
Herb Formulas	Yu Shu Dan
Points

SUDDEN TURMOIL DISORDER

Clinical Manifestations	Vomiting Abdominal distention and fullness Fever and chills Diarrhea with mucus Headache Melaena T: Pink C: Thick, white and greasy P: Soft or Floating tight and soft or Weak
Treatment Principle	Activate Qi Dry Dampness Transform turbidity Descend Qi Harmonize the Stomach Stop vomiting and diarrhea
Herb Formulas	Xing Jun San
Points