Aphasia

General

Clinical Manifestations	Aphasia is the loss of the ability to understand or express speech, caused by brain damage.
Treatment Principle
Herb Formulas
Points

Wind Invading The Channels With Qi And Blood Deficiency

Clinical Manifestations	Generalized pains Convulsions Edema Flaccid hemiplegia The patient is unable to recognize friends or identify the source of pain Stiffness with inability to rotate the trunk Confusion Muscular numbness and pain Cough Flushed face Fever Aphasia Dry stools Low-grade fever T: Normal C: Thin and yellow or Yellow and greasy P: Slippery and rapid
Treatment Principle	Support the Normal Qi Clear Heat Relax muscle tension Nourish the Blood Disperse Wind Dispel Wind-Damp
Herb Formulas	Xu Ming Tang
Points

Wind-Cold With Qi Deficiency

Clinical Manifestations	Hemiplegia Asymmetry of the face Slow and slurred speech Fever and chills Semi-consciousness Convulsions Neck rigidity Limited movement of the joints Loss of consciousness Muscle spasms Low back pain Numbness of the muscles and skin T: Pale C: Thin and white P: Floating and Deficient or Tense or Wiry and tense
Treatment Principle	Warm the channels Unblock Yang Dispel Wind Support the Normal Qi Relax spasms
Herb Formulas	Xiao Xu Ming Tang
Points

Ying Stage Heat Attacks The Pericardium

Clinical Manifestations	High fever worse at night Thirst Insomnia Major mental problems Dramatic change of personality Delirium Speech difficulty Aphasia Poor memory Dizziness Maybe fainting Maybe coma Feverish extremities T: Deep red P: Thready and rapid
Treatment Principle	Clear Heat in Pericardium
Herb Formulas	An Gong Niu Huang Wan Niu Huang Qing Xin Wan
Points	To Clear Heat from the Heart: HT-3, PC-8, Sifeng, bleed Shixuan For delirium: PC-7 To detoxify: LI-11 To Pacify Heart and calm the Shen: HT-5, HT-6, HT-7 To Nourish Yin: KI-3, SP-6

Phlegm Obstructs The Heart Orifice: Yang Obstruction

Clinical Manifestations	Sudden collapse with loss of consciousness Lockjaw (trismus) Eyes open Both fists clenched Retention of urine Constipation Stiffness and spasm of limbs Red face Body feels hot Coarse breathing Bad breath Restlessness Involuntary movements Usual sequelae of C.V.A. such as: Hemiplegia Aphasia Facial paralysis T: Pink C: Yellow and greasy P: Slippery, wiry and rapid
Treatment Principle	Clear Phlegm Open the Orifices
Herb Formulas	(Ju Fang) Zhi Bao Dan An Gong Niu Huang Wan Ling (Yang) Jiao Gou Teng Tang modified
Points	Bleed the Jing-Well points of the Six Hand channels, needle DU-20, DU-26, KI-1, LIV-3, ST-40

Phlegm Obstructs The Heart Orifice: Yin Obstruction

Clinical Manifestations	Sudden collapse with loss of consciousness Lockjaw (trismus) Eyes open Both fists clenched Retention of urine Constipation Stiffness and spasm of limbs Pale face with bluish lips Limbs cold, pale and still Lying peacefully Usual sequelae of C.V.A. such as: Hemiplegia Aphasia Facial paralysis T: Pink C: White and greasy P: Deep, slippery and even
Treatment Principle	Open the Heart Orifices with Pungent Warming Herbs Eliminate Phlegm Subdue Wind
Herb Formulas	Su He Xiang Wan Di Tan Tang Stroke #2
Points	Bleed the Jing-Well points of the Six Hand channels, needle DU-20, DU-26, KI-1, LIV-3, PC-5, ST-40, UB-20

Phlegm Obstructs The Heart Orifice: Exhaustion Syndrome

Clinical Manifestations	Sudden collapse with loss of consciousness Mouth open and hands relaxed Eyes closed Limbs cold Snoring Perspiration ("flows like oil") Incontinence of urine and feces T: Not described P: Minute and thready - about to collapse or Superficial and big but with no root (with a red face)
Treatment Principle	Support Zheng Qi Consolidate Exhaustion Strengthen Qi Return Yang
Herb Formulas	Di Huang Yin Zi Aphasia #1
Points	Moxa REN-4, REN-6, REN-8, ST-36

Liver Wind Stirring Internally: Liver Yang (Fire) Generates Wind

Clinical Manifestations	Dizziness and vertigo to the point of falling over Headache with a drawing sensation Tinnitus Blurred vision A distended feeling in the eyes A red face and ears Numbness and tremor of limbs Twitching and involuntary writhing of hands and feet Dysphasia Unsteady gait Heart vexation Irascibility With Wind-Stroke: Tongue stiffness with aphasia Facial paralysis Sudden onset of hemiplegia often after an outburst of violent anger and often preceding Sudden loss of consciousness Deviated mouth and eyes Clouded Spirit Maybe coma Sometimes death T: Red C: Slimy P: Thready and wiry or Wiry and slippery
Treatment Principle	Nourish Yin Pacify the Liver Subdue Wind
Herb Formulas	Tian Ma Gou Teng Yin Xu Ming Tang Zhen Gan Xi Feng Tang
Points	Bleed the Jing-Well points of Six Hand Channels, needle DU-20, DU-26, GB-20, GB-34, KI-1, LIV-2, LIV-3, PC-8, UB-18, UB-23 GB-30, GB-34, KI-3, LI-4, LI-11, LI-15, LIV-3, SJ-5, SP-6,, ST-36, ST-40, ST-41, UB-60 For a fever: + DU-14 For a headache: + GB-20 For body aches: + REN-12 For aversion to Cold: + UB-12 For reduced sleep and profuse dreams: + HT-7 For palpitations and deficiency vexation: + PC-6 For night sweats: + HT-6 (Early stage: treat only points on the affected side, chronic: treat bilaterally)

Liver Wind Stirring Internally: Liver Blood Deficiency Generates Wind

Clinical Manifestations	Pale complexion Pale lips Blurred or failing vision Spots before eyes Dizziness Dry eyes Pale nail beds Irritability Frightens easily Insomnia with much dreaming Tinnitus Numbness of limbs Tremor, spasms or involuntary movements (chorea) Involuntary shaking of head Light menses or amenorrhea Late menses Tic or tremor of hands and feet Maybe trismus T: Pale C: Little P: Thready and wiry
Treatment Principle	Nourish the Blood Subdue Wind
Herb Formulas	Yi Gan San
Points	DU-16, DU-20, GB-20, LIV-3, REN-4, SP-6, ST-36, UB-17, UB-18, UB-20

Liver Yin Deficiency With Liver Yang Rising

Clinical Manifestations	Dizziness Impaired vision Night blindness Tinnitus Irascibility Throbbing headache with distended feeling Flushed face Blurred vision Red, dry eyes with feeling of grit in eye Dry mouth and throat with bitter taste in mouth Palpitations Headache Nervousness Insomnia with much dreaming Dry throat Thirst Five Sole Heat (palms, soles and center of chest) Night sweats Light or late menses or Amenorrhea T: Red and dry C: Little or None P: Thready and wiry or Wiry and rapid (when Yang is Rising and Excess, pulse is forceful) or Thready and rapid when Yang is not prominent
Treatment Principle	Nourish Yin Pacify the Liver Subdue Yang
Herb Formulas	Di Huang Yin Zi
Points	DU-20, GB-20, GB-34, GB-43, KI-3, LIV-2, LIV-3, UB-18, UB-23

Liver And Kidney Yin Deficiency

Clinical Manifestations	Gradual development of hemiplegia Usually seen in elderly patients Low back and knee pain and weakness Loose teeth Hair loss Tinnitus Vertigo Impaired memory Blurred vision Inhibited speech Feeble-mindedness A somber, white facial complexion T: Normal C: White P: Deep, thready and weak
Treatment Principle	Enrich and supplement the Liver and Kidneys
Herb Formulas	Di Huang Yin Zi  modified
Points	GB-30, GB-34, KI-3, LI-4, LI-11, LI-15, REN-4, Sishencong, SJ-5, SP-6, ST-36, ST-41, UB-60 For a fever: + DU-14 For a headache: + GB-20 For body aches: + REN-12 For aversion to Cold: + UB-12 For reduced sleep and profuse dreams: + HT-7 For palpitations and deficiency vexation: + PC-6 For night sweats: + HT-6 (Early stage: treat only points on the affected side, chronic: treat bilaterally)

Liver And Kidney Yin Deficiency Generates Wind

Clinical Manifestations	Fatigue Muscle spasms with alternating flexion and extension of the extremities Prostration Clonic convulsions Dizziness - worse with stress or anger Tinnitus Aphonia Insomnia Dream-disturbed sleep Sore low back and knees Nocturnal emissions Often the patient is on the verge of shock Hemiatrophy of the muscles Hemiplegia Hemianasthesia Flaccidity of the legs T: Deep red maybe flaccid C: Thin or Peeled P: Weak and faint
Treatment Principle	Nourish the Yin of the Liver and Kidneys Extinguish Endogenous Wind Nourish the muscles
Herb Formulas	Stroke #1 With Qi and Blood Deficiency: San Bi Tang
Points

Liver And Kidney Yin Deficiency With Brain Damage

Clinical Manifestations	Paraphasia Feeble-mindedness Lack of Spirit in the eyes Motor ataxia Facial complexion pale and sallow Both cheeks slightly red Dizziness Dry eyes Blurred vision Spots before the eyes Numbness of limbs Flaccid paralysis (Wei syndrome), weakness Numbness of the limbs with limited flexion and extension Tinnitus Deafness Forgetfulness Low back and knees sore and painful Throat dry and painful Five Sole Heat Low-grade fever Night sweats Irritability Insomnia Stools difficult to pass Constipation Men: Spermatorrhea Women: Irregular menses or Scanty menses or Amenorrhea Vaginal discharge T: Red C: None P: Thready and rapid
Treatment Principle	Nourish and Reinforce the Liver and Kidneys Increase intelligence
Herb Formulas	Da Bu Yuan Jian  modified
Points	GB-20, KI-3, KI-4, Sishencong. SP-6

Jing And Blood Deficiency Due To Kidney, Heart And Spleen Deficiency

Clinical Manifestations	Fatigue Heavy and painful lower back Dream-disturbed sleep General weakness Lack of interest in food or drink Fever Night sweats Seminal emission Forgetfulness Toothache Dizziness Gum swelling General pitted Vaginal discharge Discharge of rice-water like urination without dysuria Aversion to Cold Impotence Decreased libido Emaciation Loose teeth Signs of premature aging Abdominal Cold Easily frightened T: Pale or Pale and thick C: Smooth and white P: Moderate and weak or Deep and weak
Treatment Principle	Tonify the Spleen and Kidneys Nourish the Heart Enrich the Yin Nourish the Blood and Yang Augment Qi
Herb Formulas	Huan Shao Dan Liu Wei Di Huang Wan
Points

Blood Stagnation With Qi Deficiency

Clinical Manifestations	Hemiplegia as a sequela to Wind-Stroke Insensitivity of the skin Possible stabbing pain on the affected side Hypertonicity of the sinews Possible deviation of the mouth and eyes wit sluggish speech A somber, white facial complexion Dry, scaly skin Weakness Disinclination to speak Spontaneous perspiration Lassitude Frequent urination or Enuresis T: Pale or Dark with possible maculae C: White P: Wiry and Thready or Empty and choppy
Treatment Principle	Tonify the Spleen Boost Qi Invigorates the Blood Transform Stasis
Herb Formulas	Bu Yang Huan Wu Tang  modified
Points	GB-30, GB-34, LI-4, LI-11, LI-15, REN-6, SJ-5, SP-6, ST-36, ST-41, UB-60 For a fever: + DU-14 For a headache: + GB-20 For body aches: + REN-12 For aversion to Cold: + UB-12 For frequent urination: + REN-3 For a deviated mouth and eyes: + SJ-23, ST-4, ST-6 For difficult, sluggish speech: + REN-23 For constipation: + SJ-6 (Early stage: treat only points on the affected side, chronic: treat bilaterally)

Blood Stagnation Due To A Mild Attack Of Wind Cold With Qi Deficiency

Clinical Manifestations	Relatively superficial numbness without pain Paresthesia and numbness of the skin and flesh Paresthesia of the shoulders Neck and shoulder stiffness and pain Abdominal pain alleviated by warmth and pressure Pale complexion Hemiplegia Stiff tongue Flaccidity if the extremities Migratory pain Pain, weakness, tightness or spasms of the extremities Spontaneous sweating Shortness of breath Aphasia Excess salivation Aversion to Wind T: Normal or Thick C: White or Smooth and white or White and greasy P: Faint, choppy and tight or Slightly rough and tight or Large and weak or Slow and large
Treatment Principle	Tonify Qi and Blood Warm and harmonize the channels and collaterals Harmonize the Ying and Wei Unblock painful obstruction Warm the Middle Jiao Dispel Cold Alleviate pain
Herb Formulas	Huang Qi Gui Zhi Wu Wu Tang
Points

Phlegm And Blood Stagnation

Clinical Manifestations	The tongue does not move freely Unclear speech Drooling T: Deviated C: Thin and slimy P: Slippery and slow
Treatment Principle	Break up Phlegm Open the Orifices Invigorate the Blood Break up Stasis
Herb Formulas	Dan Er Chong Tang
Points	DU-16, DU-20, HT-5, LI-4, REN-23, SP-6 (may alternate DU-16 and HT-5 with DU-15) For deviation of the mouth: + DU-26, REN-24, ST-4 For Kidney Deficiency: + KI-3, UB-23 For spasmodic or tense hemiplegia: + LI-4, LIV-3 For the hemiplegia upper limbs: + select 3-5 points from the following: LI-10, LI-11, LI-14, LI-15, SJ-5 For the hemiplegia lower limbs: + select 3-5 points from the following: GB-30, GB-31, GB-34, GB-39, ST-31, ST-32, ST-36, ST-41 For constriction of the arm: + LU-5, PC-5, PC-6 For difficult flexion of the wrist: + SJ-4 For difficult movement of the thumbs: + LI-5 For swelling or numbness of the fingers: + Baxie For contraction or difficult flexion of the knee: + LIV-8, UB-40 For swelling or numbness of the toes: + Bafeng For twisting of the leg or foot toward the inside: + KI-3, KI-6, SP-4, SP-6 For twisting of the leg or foot toward the outside: + GB-39, GB-40, UB-60, UB-62 For the foot bending downward: + GB-40, LIV-4, ST-37, ST-41

Wind-Phlegm (Feng Tan)

Clinical Manifestations	Paralysis Numbness Slurred speech Deviated eyes Deviated mouth (wry mouth) Deviated tongue Aphasia Drool flows by itself Dizziness Tinnitus Sputum in the throat Chest fullness and distention Epigastric fullness and distention Hypertension Stroke T: Deviated and trembling C: Thick or Thin and watery P: Slippery and maybe wiry or Slippery and relaxed
Treatment Principle	Resolve Phlegm Subdue Wind Open the Orifices Transform Blood Stasis
Herb Formulas	Jie Yu Dan San Sheng San Wu Yao Shun Qi San Ban Xia Bai Zhu Tian Ma Tang Gou Teng San Qian Zheng San  modified For deviated mouth and eye, difficult speech, drooling from the corners of the mouth and hemiplegia: Bu Yang Huan Wu Tang
Points	GB-20, LI-4, ST-40 Pre-stroke: ST-40, UB-40 Stroke (emergency): DU-26, KI-1, PC-9, Ting Points Post-stroke:

Wind-Cold-Damp Bi - Wind Predominant

Clinical Manifestations	Migrating pain in the joints especially the : Shoulders Elbows Knees Wrists Fingers Upper back and neck Multiple joints Pain quality changes May move from soreness to numbness to aching Sensitivity varies Pain often appears abruptly, acutely or paroxysmal and then disappears Limited range of motion Chills and fever Aversion to Wind Symptoms are worse in windy weather Sore throat General body aches Maybe perspiration T: Pink C: Thin and white or Sticky and yellow P: Superficial and moderate
Treatment Principle	Eliminate Wind Warm Cold Expel Damp Clear the Channels
Herb Formulas	Da Qin Jiao Tang  modified
Points	GB-30, GB-34, LI-4, LI-11, LI-15, SJ-5, ST-36, ST-41, UB-60 For a fever: + DU-14 For a headache: + GB-20 For body aches: + REN-12 For aversion to Cold: + UB-12 (Early stage: treat only points on the affected side, chronic: treat bilaterally) DU-14, GB-39, SJ-6 With a fever: + LI-11 With deformities: + UB-11 To disperse Qi and relieve external symptoms: LI-4, UB-12, SJ-5, GB-31 GB-20 Or GB-41, DU-1, LI-11, ST-36, UB-40 Or UB-17, SI-12, DU-16, GB-20, UB-12, SJ-17, SP-10, GB-31 Or DU-20, GB-20, GB-30 + Local points