创伤性癔病（痴呆） Hystero-Traumatis (Dementia)
50岁女性 2017.6.2 体重144磅，血压：86/70， 脉搏64
被朋友以减肥的借口带来诊所。减肥可能是她13岁时记忆中唯一明白和乐意接受的医疗术语。
37年前，因父亲去世受到刺激后痴呆。刻诊：痴呆面容，傻笑，不能理解和回答问诊的基本问题。脉压差不到20。 脉沉，双寸弱，双尺沉尤甚。足冷。
长期缺乏营养和正常生活。面色憔悴无华。脉沉，双尺尤甚，舌细长白腻，中间有裂痕，长期便溏，但肌肉丰满。
诊断：脾气虚弱，痰蒙心窍
因为无法了解更多病情，就直接开始针灸忘了在问诊时拍录像。做了前后面针。完后，决定补做一个视频，为日后康复后对比。没想到的是，仅仅前后一小时，病人已经有很大的好转。两分钟的录像显示，几乎能够理解和回答全部问题，只是语言有障碍，吐字不清。可惜没有前后录像做对比。还没有用中药就已经显示中医治疗神志病的强大优势。配合中药，加强人文训练，她极有可能恢复到过和正常人一样的简单生活。甚至有人乐意娶她。
这是一个典型医案，在经济发达的美国，很多精神病的病人由于没有得到妥善治疗，造成终生残废。通过中医治疗，癫症和狂症都可以得到不同程度的改善。
2017.6.15 血压：105/78， 心率66
2017.6.23 血压：108/82 心率：67
在7次针灸和服用中药后，在葡语翻译的帮助下，病人有了明显的进步：可以回答全部简单问题：记忆并重复三种水果的名称和顺序，正确说出三个简单数学运算：5+5=，5x5=， 5/5=。 说话基本没有结结巴巴的现象。整个过程再次做了录像。面部黄褐斑明显减轻，舌苔白腻大幅减轻，自然地大笑，不是失智的傻笑。但对针刺仍没有痛感，包括针刺手指和舌头。
说明： 拍了视频，与6.16.2017的视频相比，思维、反应、口齿、叙述、表达都有明显进步，智障已经不存在了。
2017.7.5
今天新的进步：扎针能感觉到痛了。体重减少10磅，脸上黑斑变淡了，面色变白很多。
2017.8.30
真不愿意承认失败，所以，拖了很久才发帖。
休假一个月回来，病人所有的症状都回来了。血压不到100. 舌苔变得灰白，湿气很重。口吃严重，尽管比刚来的时候好一些。但精神还好。
我们很无奈，因为病人家里没人能够照顾她，家护离开之后，没人煎药，没人车她来诊所。没有翻译，与病人沟通有大问题，基本的东西都弄不懂。但她父亲车他太太来诊所时，说病患在身体和精神方面都有很多变化。这是为什么他把他太太也带来了。
环境方面：
1、37年的脱离现实，在治疗之外，病患还需要社会的帮助回归社会。
2、缺乏基本营养和卫生环境
3、不能正确按照医嘱服药。又一次，把3天的药一次服完，这非常危险。
作为一个医生，我觉得自己能力有限，真希望能做更多。
25.Hystero-Traumatis (Dementia)
50 years old female clinic visit 2017.6.2
B/P: 86/70, pulse: 64, weight: 144 lbs.
Brought to the clinic by lulling her to get a loss-weight treatment, probably the only understandable medical term left in her memory 37 years ago. It’s said the patient extremely longs for beauty.
Typical appearance of dementia. The patient suffering dementia which triggered by the death of father 37 years ago. Blathered talk, showing unable to understand nor answer basic clinic questions independently. Answers were irrelevant and unclear.
Living in a very difficult situation, often no meals entire day, no access to any medical treatment due to undocumented immigration status.
We forgot to make a video while doing the questionnaire in the first place and quickly started acupuncture. After finishing the needling, we decided to make a make-up video instead just for comparison purpose in future when recovered. To our surprise, the video showed, with an hour in between, almost all the same questions were understandable and answered, though in a slurred way, in Portuguese, mentally different person.
This is a typical case showing TCM is a powerful healing treatment for mental illness. With herbal therapy, I believe the patient probably could get fully recovered. With only cultural training following up, she probably still can enjoy a simple and normal life.
6.15.2017 B/P：105/78，pulse:66
6.23.2017 B/P：108/82 pulse：67
After seven treatments of acupuncture and herbal therapy, the patient showed great progress. answered all questions (with a Portuguese interpreter) recalled three fruit names in right order, gave quick correct answer to 5+5=, 5 x 5= ，and 5/5= equations. Again, the whole process was videotaped. Basically, no stuttering talk, brown speckles are obviously decreased, less tongue white greasy coating, laugh naturedly, showed no silly smile. Still feels no pain on any needling, including jabs on tongue and fingers.
p.s. Compared with second video 6.16.2017, the video showed obvious progress in terms of logic, reaction, narration and expression. The symptom of dementia is gone. (Refer the photo on the left for tongue changes.)
7.5.2017
Improvement today: could feel pains on needling, lost 10lbs in weight, waistline greatly reduced. facial skin more delicate and bright, speckles even less brown. (see left picture)
2017.8.30
Delayed so long updating the case because I’m really don’t want to admit a failure in treatment.
After my return from a long holiday vacation, with only two months in between, all the symptoms are back. B/P lower than 100, tongue showed as greasy and greyish as before, stammered again, not as bad as when she came here first time though. But her spirit was higher and looked delighted. So disappointed that what we did in the past three months went nowhere.
What we are helpless about is the patient has no one in her family taking care of her, let alone cooking the herbs and driving her to the clinic. All these are relied on her roommate who is leaving for China in ten days. Most of our instruction on diet and herb-taking are not observed because the patient herself could not fully understand the significance of the change in her diet and habits. Besides we have great communication problem. However once when her dad drove his wife to the clinic for treatment, sitting by as a translator, saying he saw a lot of changes in her in last few months, mentally and physically. And that is the reason he sent his wife here for Chinese Medicine treatment.
Environmental problems:
1. Lack of cultural training to make up what the patient lost in the past thirty-seven years to gain minimum ability to survive on her own, that is what we are unable to do.
2. lack of nutrition and poor hygiene due to family situation
3. lack of people monitoring herbal taking (one day drank all the cooked herbal tea, triple-quantity)
As a solo doctor, I feel so helpless to say sorry, I wish I could do more.