Delirium in Traditional Chinese Medicine
Understanding different delirium patterns according to TCM theory
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Condition Categories
Condition Categories
Delirium, also known as an acute confused state, is a serious cognitive disorder characterized by sudden changes in awareness, attention, and cognition. Individuals experiencing delirium often exhibit disorientation, difficulty in concentrating, and rapid mood swings, along with hallucinations or delusions. This condition can arise from various medical causes, such as infections, medication side effects, or metabolic imbalances, and is more common among the elderly or those with severe illness. Delirium requires immediate medical attention, as it can signal a life-threatening situation or lead to further cognitive decline if untreated.
In Traditional Chinese Medicine (TCM), delirium is understood as a result of severe internal imbalances that disrupt the mind’s clarity and the smooth flow of Qi (vital energy). Unlike Western medicine, which focuses on underlying physical causes, TCM looks at the patterns of disharmony within the body that can lead to such an acute mental state. Identifying the correct pattern, whether it involves excessive Heat, Phlegm, or other factors, is crucial for effective treatment, as each pattern requires a different therapeutic approach.
TCM Patterns for Delirium
Heat
Intense, ascending pathogenic force that consumes body fluids, disturbs the mind, and accelerates all physiological processes
Causes: Delirium
Heat is a major pathogenic factor in Traditional Chinese Medicine that can arise from external invasion or internal generation. Heat has the characteristics of burning intensity, rising upward, consuming qi and fluids, and generating wind and disturbing blood. In TCM philosophy, normal physiological warmth is called "minor fire" (少火) which maintains life functions, while pathological heat is "major fire" (壮火) which damages the body.
Bright Yang Fire in Stomach and Intestines
Delirium
Along with: Afternoon fever, Excessive sweating, Sweating on limbs, Abdominal fullness, Abdominal pain, Constipation, Dry stools, Thirst, Dark urine, Anal burning, Irritability
Bright Yang Stomach Heat
Delirium
Along with: High fever, Excessive sweating, Excessive thirst, Flushed face, Feeling of heat, Irritability
Heat in Nutritive Qi level
Delirium
Along with: Nighttime fever, Dry mouth without desire to drink, Restlessness, Insomnia, Incoherent or confused speech, Aphasia, Macules
Heat in Pericardium
Delirium
Along with: Nighttime fever, Confusion, Incoherent or confused speech, Cold extremities
Heat in the Blood
Delirium
Along with: Feeling of heat, Red skin eruptions, Thirst, Frequent bleeding, Bloody sputum, Hematochezia, Hematuria, Vomiting blood, Cough of blood, Nosebleeds, Excessive menstruation
Wind Cold with Internal Heat
Delirium
Along with: High fever, Severe chills, Lack of sweating, Headaches, Feeling of heaviness, General sensation of tightness, Flushed face, Eye hyperemia, Dry nose, Thirst, Irritability, Insomnia, Cough of blood, Mottled skin
Cold
Congeals body fluids, damages Yang Qi, and causes pain with fixed location
Causes: Delirium
Cold is the predominant pathogenic factor of winter in Traditional Chinese Medicine. Cold represents an environmental pathogen that, when excessive, causes disease characterized by its cold, congealing, and contracting nature. While Cold is the main pathogen of winter, it can cause illness in any season through exposure to cold temperatures, getting caught in rain, sweating followed by wind exposure, or excessive air conditioning.
Bright Yang Fire in Stomach and Intestines
Delirium
Along with: Afternoon fever, Excessive sweating, Sweating on limbs, Abdominal fullness, Abdominal pain, Constipation, Dry stools, Thirst, Dark urine, Anal burning, Irritability
Bright Yang Stomach Heat
Delirium
Along with: High fever, Excessive sweating, Excessive thirst, Flushed face, Feeling of heat, Irritability
Wind Cold with Internal Heat
Delirium
Along with: High fever, Severe chills, Lack of sweating, Headaches, Feeling of heaviness, General sensation of tightness, Flushed face, Eye hyperemia, Dry nose, Thirst, Irritability, Insomnia, Cough of blood, Mottled skin
Wind
Causes sudden symptoms, movement disorders, and serves as the vehicle for other pathogens
Causes: Delirium
Wind is the predominant pathogenic factor of spring in Traditional Chinese Medicine and is considered the leader of the six external pathogens. Wind is described as "the leader of the hundred diseases" (百病之长), serving as the primary factor in external pathogenic invasions. Wind represents a pathogen characterized by constant movement, changeability, and a tendency to affect the upper and outer portions of the body.
Bright Yang Fire in Stomach and Intestines
Delirium
Along with: Afternoon fever, Excessive sweating, Sweating on limbs, Abdominal fullness, Abdominal pain, Constipation, Dry stools, Thirst, Dark urine, Anal burning, Irritability
Bright Yang Stomach Heat
Delirium
Along with: High fever, Excessive sweating, Excessive thirst, Flushed face, Feeling of heat, Irritability
Wind Cold with Internal Heat
Delirium
Along with: High fever, Severe chills, Lack of sweating, Headaches, Feeling of heaviness, General sensation of tightness, Flushed face, Eye hyperemia, Dry nose, Thirst, Irritability, Insomnia, Cough of blood, Mottled skin
Phlegm
Thick, sticky pathological fluid that obstructs body functions and can manifest anywhere in the body
Causes: Delirium
Phlegm is both a pathological product and a pathogenic factor in Traditional Chinese Medicine. It results from impaired fluid metabolism when the body's transformative functions fail, particularly affecting the Spleen, Lungs, and Kidneys. Classical texts emphasize that "the Spleen is the source of phlegm production, while the Lungs are the storage vessel for phlegm."
Phlegm
Delirium
Along with: Stifling sensation in the chest, Head fog, Dizziness
Herbal Formulas for Delirium
Traditional Chinese Medicine formulas used to address delirium
Qing Ying Tang
Addresses these delirium patterns:
Main Actions
- Cools the Nutritive Level
- Resolves Heat Toxins
- Vents Pathogenic Heat Outward
- Nourishes Yin
- Generates Fluids
- Cools the Blood
- Invigorates Blood and Dispels Stasis
Addresses These Delirium Pattern Variations
Heat in Nutritive Qi level
How it manifests:
Delirium
Accompanying symptoms:
Nighttime fever, Dry mouth without desire to drink, Restlessness, Insomnia, Incoherent or confused speech, Aphasia...
Heat in Pericardium
How it manifests:
Delirium
Accompanying symptoms:
Nighttime fever, Confusion, Incoherent or confused speech, Cold extremities
Heat in the Blood
How it manifests:
Delirium
Accompanying symptoms:
Feeling of heat, Red skin eruptions, Thirst, Frequent bleeding, Bloody sputum, Hematochezia...
Bai He Di Huang Tang
Addresses these delirium patterns:
Main Actions
- Nourishes Yin
- Clears Deficiency Heat
- Moistens the Lungs
- Cools the Blood
- Calms the Spirit
Addresses These Delirium Pattern Variations
Heat in Nutritive Qi level
How it manifests:
Delirium
Accompanying symptoms:
Nighttime fever, Dry mouth without desire to drink, Restlessness, Insomnia, Incoherent or confused speech, Aphasia...
Heat in the Blood
How it manifests:
Delirium
Accompanying symptoms:
Feeling of heat, Red skin eruptions, Thirst, Frequent bleeding, Bloody sputum, Hematochezia...
Bai Hu Tang
Addresses these delirium patterns:
Main Actions
- Clears Heat from the Qi level
- Clears Stomach Heat
- Generates Fluids
- Generates Fluids and Relieves Thirst
- Eliminates Irritability
Addresses These Delirium Pattern Variations
Bright Yang Stomach Heat
How it manifests:
Delirium
Accompanying symptoms:
High fever, Excessive sweating, Excessive thirst, Flushed face, Feeling of heat, Irritability
Banxia Baizhu Tianma Tang
Addresses these delirium patterns:
Main Actions
- Transforms Wind-Phlegm and Stops Spasms
- Strengthens the Spleen and Resolves Dampness
- Calms the Liver and stops dizziness
- Directs Rebellious Qi Downward and Stops Vomiting
- Regulates Qi and Transforms Phlegm
Addresses These Delirium Pattern Variations
Phlegm
How it manifests:
Delirium
Accompanying symptoms:
Stifling sensation in the chest, Head fog, Dizziness
Er Chen Tang
Addresses these delirium patterns:
Main Actions
- Dries Dampness and Transforms Phlegm
- Regulates Qi and Harmonizes the Middle Burner
- Directs Rebellious Qi Downward and Stops Vomiting
- Strengthens the Spleen and Resolves Dampness
- Disperses stagnation in the chest and diaphragm
Addresses These Delirium Pattern Variations
Phlegm
How it manifests:
Delirium
Accompanying symptoms:
Stifling sensation in the chest, Head fog, Dizziness
Gu Jing Wan
Addresses these delirium patterns:
Main Actions
- Nourishes Yin
- Clears Heat
- Secures the Menses and Stops Uterine Bleeding
- Stops Bleeding
- Secures the Chong and Ren Vessels
Addresses These Delirium Pattern Variations
Heat in the Blood
How it manifests:
Delirium
Accompanying symptoms:
Feeling of heat, Red skin eruptions, Thirst, Frequent bleeding, Bloody sputum, Hematochezia...
Hao Qin Qing Dan Tang
Addresses these delirium patterns:
Main Actions
- Clears Liver and Gallbladder Heat
- Harmonizes the Shaoyang
- Clears Damp-Heat
- Harmonizes the Stomach
- Resolves Phlegm
- Moves Qi
Addresses These Delirium Pattern Variations
Phlegm
How it manifests:
Delirium
Accompanying symptoms:
Stifling sensation in the chest, Head fog, Dizziness
Hua Ban Tang
Addresses these delirium patterns:
Main Actions
- Clears Heat from the Qi level
- Cools the Blood
- Resolves Toxicity
- Cools the Blood and Resolves Macules
- Nourishes Yin
Addresses These Delirium Pattern Variations
Heat in the Blood
How it manifests:
Delirium
Accompanying symptoms:
Feeling of heat, Red skin eruptions, Thirst, Frequent bleeding, Bloody sputum, Hematochezia...
Liu Junzi Tang
Addresses these delirium patterns:
Main Actions
- Tonifies Qi
- Strengthens the Spleen
- Harmonizes the Stomach
- Dries Dampness
- Resolves Phlegm
Addresses These Delirium Pattern Variations
Phlegm
How it manifests:
Delirium
Accompanying symptoms:
Stifling sensation in the chest, Head fog, Dizziness
Qing Re Gu Jing Tang
Addresses these delirium patterns:
Main Actions
- Clears Heat and Cools the Blood
- Secures the Menses and Stops Uterine Bleeding
- Nourishes Yin and Clears Deficiency Heat
- Astringes to Stop Uterine Bleeding
Addresses These Delirium Pattern Variations
Heat in the Blood
How it manifests:
Delirium
Accompanying symptoms:
Feeling of heat, Red skin eruptions, Thirst, Frequent bleeding, Bloody sputum, Hematochezia...
Shi Gao Tang
Addresses these delirium patterns:
Main Actions
- Clears Heat and Resolves Toxicity
- Releases the Exterior
- Clears Heat from the Three Burners
- Releases the Exterior and Warms the Interior
Addresses These Delirium Pattern Variations
Wind Cold with Internal Heat
How it manifests:
Delirium
Accompanying symptoms:
High fever, Severe chills, Lack of sweating, Headaches, Feeling of heaviness, General sensation of tightness...
Shi Hui San
Addresses these delirium patterns:
Main Actions
- Cools the Blood and Stops Bleeding
- Clears Heat and Drains Fire
- Drains Fire
- Dispels Stasis to Promote Healing
Addresses These Delirium Pattern Variations
Heat in the Blood
How it manifests:
Delirium
Accompanying symptoms:
Feeling of heat, Red skin eruptions, Thirst, Frequent bleeding, Bloody sputum, Hematochezia...
Tiao Wei Cheng Qi Tang
Addresses these delirium patterns:
Main Actions
- Mildly Purges Heat Accumulation
- Softens Hardness and Moistens Dryness
- Harmonizes the Stomach
- Clears Interior Heat
- Promotes Bowel Movement
Addresses These Delirium Pattern Variations
Bright Yang Fire in Stomach and Intestines
How it manifests:
Delirium
Accompanying symptoms:
Afternoon fever, Excessive sweating, Sweating on limbs, Abdominal fullness, Abdominal pain, Constipation...
Wen Dan Tang
Addresses these delirium patterns:
Main Actions
- Regulates Qi and Transforms Phlegm
- Clears Gallbladder and Stomach Heat
- Dries Dampness
- Stops vomiting and eliminates irritability
Addresses These Delirium Pattern Variations
Phlegm
How it manifests:
Delirium
Accompanying symptoms:
Stifling sensation in the chest, Head fog, Dizziness
Xi Jiao Di Huang Tang
Addresses these delirium patterns:
Main Actions
- Clears Heat and Resolves Toxicity
- Cools the Blood
- Invigorates Blood and Dispels Stasis
- Nourishes Yin
Addresses These Delirium Pattern Variations
Heat in the Blood
How it manifests:
Delirium
Accompanying symptoms:
Feeling of heat, Red skin eruptions, Thirst, Frequent bleeding, Bloody sputum, Hematochezia...
Xiao Cheng Qi Tang
Addresses these delirium patterns:
Main Actions
- Mildly Purges Heat Accumulation
- Promotes Bowel Movement
- Moves Qi and Relieves Distension
- Eliminates distention and disperses clumping
Addresses These Delirium Pattern Variations
Bright Yang Fire in Stomach and Intestines
How it manifests:
Delirium
Accompanying symptoms:
Afternoon fever, Excessive sweating, Sweating on limbs, Abdominal fullness, Abdominal pain, Constipation...
Xing Su San
Addresses these delirium patterns:
Main Actions
- Gently disperses Cool Dryness
- Diffuses Lung Qi
- Resolves Phlegm
- Stops Cough
- Releases the Exterior
- Resolves Phlegm-Fluid Retention
Addresses These Delirium Pattern Variations
Phlegm
How it manifests:
Delirium
Accompanying symptoms:
Stifling sensation in the chest, Head fog, Dizziness
Zhi Bao Dan
Addresses these delirium patterns:
Main Actions
- Opens the Orifices and Revives Consciousness
- Transforms Turbidity
- Clears Heat
- Resolves Toxicity
- Calms the Spirit and Relieves Restlessness
- Expels Phlegm
Addresses These Delirium Pattern Variations
Heat in Pericardium
How it manifests:
Delirium
Accompanying symptoms:
Nighttime fever, Confusion, Incoherent or confused speech, Cold extremities