Alzheimer's disease & Chinese medicine - Chinese Medicine Update - Excerpt

Townsend Letter for Doctors and Patients,  July, 2002  by Bob Flaws

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Keywords: Alzheimer's disease, Chinese medicine, Chinese herbal medicine, acupuncture, senile dementia

In Chinese medicine, Alzheimer's disease is not yet recognized as a separate disease entity. Instead, it falls under the generic category of senile dementia. The following protocols have been excerpted from my and Philippe Sionneau's The Treatment of Modern Western Medical Diseases with Chinese Medicine published by Blue Poppy Press in 2002. These protocols are representative of the standard professional Chinese medical treatment of senile dementia.

Chinese disease categorization: Alzheimer's disease is categorized as lao nian xing chi dai, literally, senile feeblemindedness but commonly translated as senile dementia, wen chi, civil madness, and wu chi martial mania, in Chinese medicine. In the latter case, there is marked impetuosity, irritability, red face and eyes, restlessness, and agitated movement.

Disease causes: Former heaven natural endowment insufficiency, aging, internal damage by the seven affects, and unregulated eating and drinking.

Disease mechanisms: Due to former heaven natural endowment insufficiency and aging, there may be insufficient yin blood to transform essence and fill the sea of marrow or yang qi debility with loss of spiritual brightness. In either case, there may be decreased mental clarity and faulty memory. However, faulty or impaired memory and spirit abstraction may also be due to simple heart blood vacuity. If yin fails to control yang, liver yang may become hyperactive and ascend or heart fire may become hyperactive and exuberant. These mechanisms typically give rise to irritability, vexation and agitation, restlessness, and even hostility and aggression. Less pronounced irritability and tactiturnity may be due to liver depression, with or without depressive heat. Faulty diet as well as heat stewing the juices may result in the engenderment of phlegm dampness which may mist the portals, causing mental confusion and aphasia. If yin and blood vacuity, fire heat, or phlegm give rise to internal stirring of liver wind, th ere may be convulsions and tremors. If there is liver depression qi stagnation, as there surely must be due to the frustration of this condition, this may give rise to blood stasis. Blood stasis may also be due to heart vacuity, liver blood vacuity, and phlegm obstruction as well as prolonged sitting and inactivity. Typically, several of these disease mechanisms combine in any given patient.

Treatment Based on Pattern Discrimination

1. Liver depression qi stagnation mixed with phlegm & stasis pattern

Main symptoms: Heart vexation, easy anger, depression, oppression, and emotional dysphoria, no desire to speak, bilateral rib-side distention and pain, a dark tongue with possible static macules and slimy fur, and a bowstring, slippery pulse

Treatment principles: Course the liver and rectify the qi, quicken the blood and dispel phlegm

Rx: Wu Shi Gan Yu Fang Jia Wei (Master Wu's Liver Depression Formula with Added Flavors)

Ingredients: Radix Ligustici Wallichii (Chuan Xiong) and Radix Salviae Miltiorrhizae (Dan Shen), 15g each, Semen Pruni Persicae (Tao Ren), Flos Carthami Tinctorii (Hong Hua), Radix Rubrus Paeoniae Lactiflorae (Chi Shao), and Rhizoma Cyperi Rotundi (Xiang Fu), 12g each, Rhizoma Pinelliae Ternatae (Ban Xia), Radix Bupleuri (Chai Hu), Pericarpium Citri Reticulatae (Chen Pi), Pericarpium Citri Reticulatae Viride (Qing Pi), and RhizomaAcori Graminei (Shi Chang Pu), 9g each

Analysis of formula: Xiang Fu, Chai Hu, and Qing Pi course the liver and resolve depression. Chen Pi, Ban Xia, and Shi Chang Pu dry dampness and transform phlegm. In addition, Shi Chang Pu opens the orifices and arouses the spirit. Chuan Xiong, Dan Shen, Tao Ren, Hong Hua, and Chi Shao quicken the blood and transform stasis.

Additions & subtractions: If there is depressive heat, add nine grams each of Fructus Gardeniac Jasminoidis (Zhi Zi) and Cortex Radicis Moutan (Dan Pi). If there is blood vacuity, add nine grams of Radix Angelicae Sinensis (Dang Gui) and replace Red Peony with Radix Albus Paeoniae Lactiflorae (Bai Shao). If there is spleen vacuity, add nine grams each of RhizomaAtracty lodis Macrocephalae (Bai Zhu) and Sclerotium Poriae Cocos (Fu Ling) and six grams of mixfried Radix Glycyrrhizae (Gan Cao).

Acupuncture & moxibustion: Bai Hui (GV 20), Si Shen Cong (M-HN-1), Tai Chong (Liv 3), San Yin Jiao (Sp 6), Feng Long (St 40)

Analysis of formula: Draining Bai Hui and Si Shen Cong opens the orifices, arouses the spirit, and boosts the intelligence. Draining Tai Chong courses the liver and resolves depression, San Yin Jiao quickens the blood and transforms stasis, while Feng Long dries dampness and transforms phlegm.

Additions & subtractions: For long term treatment, alternate the above points with Shen Ting (GV 24), Qian Ding (GV 21), Hou Ding (GV 19), Ge Sha (Bl 17), Gan Shu (Bl 18), Hun Men (Bl 47), and Pi Sha (Bl 20). For depressive heat, replace Tai Chong with Xing Jian (Liv 2) and add Xia Xi (GB 43). For blood vacuity, add Ge Shu (Bl 17) and Gan Shu (Bl 18). For spleen vacuity, add Zit San Li (St 36). For bilateral rib-side distention and pain, add Zhang Men (Liv 13).