Deranged+Speech+(Yan+Yu+Cuo+Luan)

In Chinese medicine, deranged speech refers to incoherent, illogical, nonsensical speech.

Differential Diagnosis: A. Delirium B. Dementia C. Cerebrovascular Accdent (CVA) D. Tic Disorders E. Traumatic Brain Injury F. Seizure Disorders G. CNS Tumors A. Schizophrenia and other psychotic disorders B. Acute Mania in Bipolar Disorders or Schizo-affective Disorder C. Pervasive Development Disorders
 * Medical Disorders:**
 * Psychiatric Disorders:**

TCM Etiology & Pathogenesis: “Speech is a function of the heart. When heart Qi and blood are replete and exuberant, and the heart spirit is quiet, the speech is orderly and coherent. However, when the heart Qi and blood are insufficient to construct and nourish the spirit and its functions, then the spirit may become disquieted, the functions of the heart may lose their duty, and the speech may become deranged. Hence, deranged speech is primarily associated with either lack of construction and nourishment of the heart spirit or harassment and blockage of the heart spirit by the three evil Qi of phlegm, heat, and static blood”1

TCM Pattern Differentiation: Heart –Spleen Dual Vacuity 1 Deranged speech, disinclination to speak, insomnia, heart palpitations, fatigue, lassitude of the spirit, cold hands and feet, a tendency to loose stools, poor appetite, a sallow yellow or pale white facial complexion, pale lips and nails, lack of strength [ Huang Qi (10-15g.), Dang Shen (10g.), Bai Zhu (10g.), Fu Shen (12g.), Gan Cao (6-12g.), Dang Gui (6-10g.), Long Yan Rou (10g.), Yuan Zhi (6-10g.), Mu Xiang (6g.), Shi Chang Pu (6g.), Sheng Jiang (3g.) Da Zao (3-5 pieces
 * Tongue:** pale, fat tongue w/ teeth marks on edges
 * Pulse:** fine, weak, possibly slow
 * Treatment Principles:** Supplement the heart and nourish the blood, fortify the spleen and boost the Qi
 * Acupuncture Treatment:** CV-23, HT-5, SP-6, ST-36, BL-15, BL-20. Even technique
 * Herbal Treatment:** Gui Pi Tang Jia Wei1

Yin Vacuity-Blood Dryness 1 Deranged speech, emotional lability, alternating joy and crying without apparent reason, insomnia, heart palpitations, fatigue, a dry throat, possible night sweats, agitation [Gan Cao(10-15g.),Huai Xiao Mai(15-30g.),Bai He(30g.),Suan Zao Ren (12g.),Zhi Mu (10g.),Bai Shao (10g.),Da Zao (10 pieces)]
 * Tongue:** red, scanty dryish coat
 * Pulse:** fine, possibly rapid, possibly bowstring
 * Treatment Principles:** Enrich Yin and nourish the blood, clear heat and quiet the spirit
 * Acupuncture Treatment:** SP-6, KI-3, HT-7, HT-5, CV-23, BL-15, BL-17. Even technique
 * Herbal Treatment:** Gan Mai Da Zao Tang Jia Jian1

Liver Depression Qi Stagnation 1 Deranged speech, irritability, emotional depression, taciturnity, chest oppression, rib-side distention [Chai Hu (6g.), Zhi Ke (10g.), Bai Shao (10g.), Gan Cao (6g.), Fo Shou (10g.), Xiang Yuan (10g.), Mei Gui Hua (10g.), He Huan Hua (12g.), Shi Chang Pu (6-10g.)]
 * Tongue:** normal or slightly darkish tongue, thin white coat
 * Pulse:** fine, bowstring
 * Treatment Principles:** Course the Liver and resolve depression
 * Acupuncture Treatment:** LR-3, LI-4, LR-14, CV-23, HT-5. Draining Technique
 * Herbal Treatment:** Si Ni San Jia Wei1
 * Modifications:** Insomnia: + Yuan Zhi, Suan Zao Ren

Phlegm Dampness Cofounding the Orifices 1 Deranged speech, muttering to oneself, slow reactions, mental-emotional confusion or abstraction, dizziness and vertigo, nausea and vomiting, chest and abdominal oppression and fullness, profuse phlegm [Ban Xia (10g.), Tian Nan Xing (10g.), Zhi Shi (6g.), Bai Zhu (10g.), Fu Ling (10g.), Chen Pi (6g.), Yuan Zhi (6-10g.), Shi Chang Pu (6g.), Gan Cao (3-6g.), Sheng Jiag (3g.)] With Spleen Qi vacuity: + Dang Shen, Huang Qi Simultaneous heart vacuity with insomnia & palpitations: + Suan Zao Ren, Wu Wei Zi, Bai Zi Ren, Dang Shen
 * Tongue:** swollen, fat tongue, slimy white coat
 * Pulse:** slippery, bowstring
 * Treatment Principles:** Transform phlegm and dry dampness, open the orifices and quiet the spirit
 * Acupuncture Treatment:** ST-40, CV-12, ST-36, SP-9, CV-23, HT-5. Even Technique
 * Herbal Treatment:** Dao Tan Tang1
 * Modifications:**

Phlegm Fire Harassing Above 1 Deranged speech, muttering to oneself, slow reactions, mental-emotional confusion or abstraction, dizziness and vertigo, nausea and vomiting, chest and abdominal oppression and fullness, profuse yellow phlegm, irritability or even irascibility [Huang Lian (3-6g.), Huang Qin (10g.), Shi Chang Pu (6g.), Dan Nan Xing (3-6g.), Ban Xia (10g.), Chen Pi (6-10g.), Fu Shen (12g.), Zhi Shi (6g.), Zhu Ru (6-10g.), Gan Cao (3-6g.), Da Zao (3-5 pieces)]
 * Tongue:** red tongue, slimy yellow coat
 * Pulse:** slippery, bowstring, rapid
 * Treatment Principles:** Transform phlegm and clear heat, open the orifices and quiet the spirit
 * Acupuncture Treatment:** ST-40, ST-41, LR-2, CV-17, CV-12, CV-23, HT-5. Draining Technique
 * Herbal Treatment:** Huang Lian Wen Dan Tang Jia Wei1

Blood Stasis Obstructing Internally 1 Deranged speech, especially premenstrually or postpartum in females with either dysmenorrheal or abdominal pain and scanty lochia, possible menstrual irregularity, dark dusky facial complexion, spider nevi, hemangiomas, or varicosities **Tongue:** purple red or possible static spots or macules; engorged, tortuous sublingual veins [Tao Ren (10g.), Hong Hua (10g.), Shu Di (12g.), Dang Gui (10g.), Chi Shao (10g.), Chuan Xiong (10-15g.), Yuan Zhi (6-10g.), Shi Chang Pu (6g.)
 * Pulse:** bowstring, choppy or bound
 * Treatment Principles:** Quicken the blood and transform stasis, open the orifices and quiet the spirit
 * Acupuncture Treatment:** SP-10, SP-6, LI-4, CV-23, HT-5. Draining Technique
 * Herbal Treatment:** Tao Hong Si Wu Tang Jia Wei1
 * Modifications:** Simultaneous Qi vacuity: + Huang Qi, Dang Shen