Introduction
Schizophrenia is clinically marked by incoordination in thinking, perception, sentiment, consciousness and behavior as well as adaptation to environment. The main manifestations are hallucination, illusion, incoherency in thinking, indifference or hyperaffectivity, excitation or stupor and lack of self-awareness. Schizophrenia is similar to mania in TCM. It is usually caused by long-term mental depression, rage and fright that lead to stagnation of liver qi and transformation of fire from qi stagnation; or by production of phlegm from qi stagnation and obstruction by interaction of phlegm and qi; or by prolonged qi stagnation and blood stasis in the vessels; or by impairment of both the heart and spleen and insufficiency of qi and blood that affect cardiac spirit.
Syndrome Differentiation
1. Exuberance of Heart and Liver Fire
Excitation, mania, keeping awake all night, flushed cheeks, glowering eyes, polylogia, coprolalia, abnormal increase of strength, dry feces, yellow and brown urine, tongue with red tip and margins, thin, yellow and dry tongue fur, taut and rapid pulse.
2. Stagnation of Phlegm and Qi
Mental depression, indifference, dementia, dull eyes, grayish and yellowish or dropsy complexion, divagation, anorexia, bulgy tongue, white and greasy tongue fur, taut and slippery pulse.
3. Qi Stagnation and Blood Stasis
Long-term mania, mental instability, susceptibility to emotional changes, delusion and insomnia, dull complexion, dry skin, dry feces, purplish tongue, deep and unsmooth pulse.
4. Asthenia of Both the Heart and Spleen
Trance, depression, palpitation and susceptibility to fright, susceptibility to sorrow, preference for quietness and inactivity, indifference and silence, lusterless complexion, reduced appetite, light-colored tongue with thin fur, thin, soft and weak pulse.
Treatment
1. Body Acupuncture
Prescription:
Baihui (GV 20), Daling (PC 7) and Fenglong (ST 40).
Modification: For exuberance of heart and liver fire, Shuigou (GV 26) , Shaoshang (LU 11), Laogong (PC 8), Dazhui (GV 14) and Yinbai (SP 1) are added; for stagnation of phlegm and qi, Shenmen (HT 7), Jianshi (PC 5) and Tanzhong (CV 17) are added; for stagnation of qi and stasis of blood, Hegu (LI 4), Quchi (LI 11) and Taichong (LR 3) are added; for asthenia of both the heart and spleen, Xinshu (BL 15) , Pishu (BL 20), Zusanli (ST 36) and Sanyinjiao (SP 6)
Performance:
Asthenia of both the heart and spleen can be treated with reinforcing needling technique. Back-Shu acupoints can be moxibusted after needling. The rest of the acupoints can be needled with reducing or mild reinforcing and reducing needling techniques. Shaoshang (LU11) and Yinbai (SP 1) can be punctured to let out blood. The needles are retained for about 30 - 40 minutes and manipulated at intervals. Cares should be taken to avoid bending and breaking the needles.
2. Electro-Acupuncture
Prescription:
Each time 1 - 2 pairs of acupoints mentioned are selected.
Performance:
After the needling sensation is felt, impulse current is attached to the needles. The needles are retained for 20 minutes. Such a treatment is given once a day.