Dr. Jin Shu Bai
Case A-5
page 73
Pseudo Mania Withdrawal
Yao XX XX, female, age 30.
The patient had the experience of feeling the presence of “ghost and spirits.” When it occurred at night she would have dreams of spirits and at daytime she would yawn frequently and belch loudly. Sometimes she laughed or talked to herself, at times she would ?…? sing and not cease. The pulse was slippery, and the tongue had a red tip and yellow, slimy fur.
Pattern Identification: Due to not accomplishing aims, phlegm and qi interacted and congealed, there was frenetic movement of the ministerial fire, and the spirit was not residing in its abode.
Treatment Principle: Drain the liver and sweep phlegm, quiet the spirit and quiet the will.
Point Selection: Ren Zhong (GV-26), connected to Yin Jiao (CV-7); the appropriate sensation should be intense enough to make the eyes tear. Shang Wan (CV-13), Zhong Wan, and (CV-12); each is inserted to a depth of 8 fen, and lifting-thrusting rotational method is applied for draining method. Jian Shi (PC-5), Li Gou (LV-5), and Tai Chong (LV-3) are used with rotational method for draining. In this patient’s case, needling was done on alternate days. After ten treatments the disease was cured.
Comment: This patient had chaotic heart and spirit with laughing and talking to herself, unceasing singing, and frequent attacks when under mentally duress; when this passed she was like any normal person. In the pattern of mania withdrawal* the symptoms of mental irregularities are very rarely able to resolve themselves; in fact, years accumulate and months pass by with no cure. Thus, this case was termed a “pseudo mania withdrawal” and it should be differentiated from true mania withdrawal. In acupuncture therapy, however, one can give the same treatment to different diseases. Ren Zhong connected to Yin Jiao was selected to drain yang, and settle tranquility. Shang Wan, and Zhong Wan harmonize the stomach and transform phlegm. Jian Shi clears the heart and drains fire. Li Gou and Tai Chong calm the liver and drain fire. All of these points combine effectively and take different paths to the same goal. This clever way of identifying patterns and determining treatment is precisely one of Dr. Jin’s special features.
*What is implied here by the name is a case where there are both signs of mania and withdrawal in the same patient. However, the claims that symptoms rarely resolve themselves and that a prolonged illness with no cure seems to represent some confusion with schizophrenia.