Condition Treated / Emotional / Behaviour Conditions




Dementia is an acquired progressive cognitive functional disturbance syndrome. The mental
disturbances include variable damage to the function of memory, speech, or vision, abnormal
personality, and low perceptibility. It may be accompanied by abnormal behavior and display of
affection. Basic daily functions, social activities, and work capabilities are decreased
significantly. The incidence of this disease increases with age.

Causes and Pathogenesis of the Disease

The basic pathological mechanisms in TCM of dementia are depletion of the liver and kidney, and an insufficiency of qi and blood which causes insufficient nutrition to the channels and the brain.
When the patient is middle-aged, the five zang-organs are deficient, especially the liver and the
kidney. The insufficiency of essence and blood cause emptiness in the brain, which causes the
dysfunction of the mind. The impairment of the liver and kidney will cause up-flaming of the
deficient fire, which creates disharmony between the heart and kidney. Sometimes the insufficient
qi and blood cannot provide enough nutrition to the heart which causes a confused state of mind.
Dysfunction of the spleen produces phlegm within the body, which goes upwards toward the obstructed upper orifices and manifests as symptoms of dementia. When the zang-qi is deficient, there will be no power to circulate blood, which then produces blood stagnation in the collaterals of the brain.

Identification of Patterns

Chief symptoms The symptoms in the early stage are slight impairment of memory, thinking,
and creativity; low adaptability to the environment, poor concentration, lack of energy and
anxiety. The following symptoms are disturbances in memory, cognition, personality, speech, and
mind. It can also appear as manifestations of neural functional disorders, such as limb apraxia,
paralysis, ataxia, epilepsy and pyramidal signs.
The pattern of depletion of the liver and kidney can manifest as crying or laughing suddenly,
irritability, madness, dizziness, numbness of the hands and feet, insomnia, a red tongue with a
thin yellow coating and a wiry, rapid pulse.

The pattern of qi and blood deficiency can qe accompanied by abnormaJ behavior and expression, speechlessness, laughing or singing suddenly, foul mood, unsteady ambulation, a pale complexion, shortness of breath, fatigue, a pale tongue with a white coating and a thready, weak pulse.

The pattern of phlegm blocking the upper orifices can manifest as having a witless expression, slow actions, quietness, preference to sit or lay down, urinary and fecal incontinence, a fat, pale, mildly swollen tongue with teeth marks, a white, thick and greasy tongue coating and a slippery pulse.

The pattern of blood stasis in the collaterals can be accompanied by a indifferent
expression, slow reaction, quietness, forgetfulness, hyperarousal, a dark, purple tongue with
petechia and a thready, rough pulse.


(1) Primary treatment
Principal points Baihui (GV 20), Sishencong (EX-HN1), Taixi (KI 3), Dazhong (KI 4), Xuanzhong (GB 39), and Zusanli (ST 36).
Supplementary points Add Ganshu (BL 18) and Sanyinjiao (SP 6) to the pattern of depletion of
the liver and kidney; add Qihai (CV 6) and Geshu (BL 17) to the pattern of qi and blood deficiency;
add Fenglong (ST 40) and Zhongwan (CV 12) to the pattern of phlegm blocking the upper orifices; and add Geshu (BL 17) and Weizhong (BL 40) to the pattern of blood stasis in the collateras.

Explanation The brain, or the sea of the marrows, is the location of this disease.
The points of Baihui (GV 20) and Sishencong (EX-HNl), which are connected to the brain through the Governor vessel, can awaken the brain and calm the spirit. Taixi (KI 3) and Dazhong (KI 4) can
nourish the kidney and the marrows. Xuanzhong (GB 39), which is the Influential Point of the marrow can nourish the marrow and can torrify the brain to improve intelligence. Zusanli (ST 36), which nourishes the acquired constitution of the body, can promote the transformation of the qi and blood and assist the source of the marrow.

(2) Alternate methods of treatment
Auricular acupuncture Select 5 to 6 points from Shenmen (TF 4), Subcortex (AT 4), Sympathesis (AH 6a), Adrenal Galand (TG 2p), Heart (CO 15) , Liver (CO 12), and Kidney (CO 10) for treatment using filiform needles for a duration of 20 minutes once daily, with ten treatments constituting a full course. The above points can also be treated by ear-pressure with wang bu liu xing (Semen Vaccariae). Replace them every 3 to 5 days. Scalp acupuncture Select the Middle Line of the Vertex (MSS), the Middle Line of the Forehead (MSl), the Anterior Temporal Line (MSlO) and the Posterior Temporal Line (MSll). Insert the needle transversely along the scalp and manipulate the needle using a fast rotation, and then retain the needle for 10 to 20 minutes once daily. It can also be combined with electro-acupuncture using intermediate stimulation with a sparse-dense wave.

Acupuncture may obtain a good therapeutic effect for dementia especially in the early stage. A
clear diagnosis in both TCM and western medicine is necessary in order to determine the main causes and deal with the primary diseases accordingly.

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