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
- Clears the Nutritive level Heat
- Relieves Fire Toxin
- Removes Heat
- Nourishes Yin
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
- Moistens the Lungs
- Enriches the Body Fluids
- Clears Heat and cools the Blood
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 Qi-level Heat
- Drains Stomach Fire
- Generates fluids
- Alleviates thirst
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
Ban Xia Bai Zhu Tian Ma Tang
Addresses these delirium patterns:
Main Actions
- Dries and dissolves Phlegm
- Strengthens the Spleen
- Soothes the Liver and calms Liver Wind (antispasmodic)
- Clear Dampness
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 Damp and dispels Phlegm
- Regulates Qi and harmonizes the Middle Burner (Stomach and Spleen)
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
- Stops bleeding
- Stabilizes the menses
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 Heat and relieves acute conditions of the Gallbladder
- Relieves acute Damp-Heat syndromes
- Resolves Phlegm
- Harmonizes the Stomach
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 Qi-level Heat
- Cools the Blood
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 Jun Zi Tang
Addresses these delirium patterns:
Main Actions
- Tonifies Qi
- Strengthens the Spleen and Stomach
- Clears Phlegm and mucus
- Promotes appetite
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 Empty Heat
- Tonifies the Kidney Yin
- Stops bleeding
- Supplies Body Fluids
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
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
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
- Removes Heat and Dryness in the Lower Burner
- Removes constipation
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
- Clears Phlegm
- Clears Gallbladder
- Regulates Qi
- Harmonizes the Stomach
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
- Treats severe fevers and Heat in the Blood system
- Removes Blood Stagnation
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
- Moderately purges Heat accumulation
- Circulates Qi in the Middle
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
- Clears Dry-Cold
- Disseminates the Lung Qi and relieves cough
- Transforms thin mucus
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
- Clears Heat
- Opens the sensory orifices
- Resolves toxicity
- Transforms Phlegm
Addresses These Delirium Pattern Variations
Heat in Pericardium
How it manifests:
Delirium
Accompanying symptoms:
Nighttime fever, Confusion, Incoherent or confused speech, Cold extremities