Confusion Delirium and Ghost-Seeing

Confusion (Delirium and Ghost-Seeing)

After a severe illness such as typhoid fever, patients may feel neither hungry nor sleepy, unable to move or act, with a confused state of mind, as if possessed by ghosts or spirits, known as "Lily Disease." This term refers to a unified pattern among all diseases, with the lungs being the master of all meridians, and when lung qi is unsettled, the disease manifests in this way. Many cases of confusion remain unnamed, but all show signs of red, rapid pulses, indicating that the lung metal element is being suppressed. Zhang Zhongjing used Shengdi, Baihe, and Huashi to treat such cases. This section specifically discusses residual pathogenic factors from miscellaneous diseases affecting patients. For patients with blood loss, whose yin meridians are injured, all cases of confusion and restlessness fall under the category of Lily Disease, requiring primarily clearing the metal element and stabilizing the spirit. Clearing dryness and rescuing the lungs with Baihe, Fushen, Amber, Huashi, Shengdi, and Jinbo Zhenxin Wan is recommended, along with Di Po Tang, or Qiongyu Gao with Longgu, Lingyang Jiao, Baihe, and Shengdi, or Renshen Qingfei Tang with Baihe and Huashi.

Generally, when dreams at night are disturbed, it indicates that the soul is uneasy. The soul is yang, and at night it hides and remains dormant; if it cannot hide, dreams at night become disturbed. When awake, confusion indicates that the spirit is uneasy. The spirit is yin, and when awake, yin qi is insufficient, leading to confusion and restlessness. Treatment of the soul focuses on the liver, while treatment of the spirit focuses on the lungs, and the two are clearly distinct. However, confusion, palpitations, bewilderment, anxiety, and delirium are all manifestations of an unclear spirit. The human body has both soul and spirit, and the entity that governs them is the spirit itself. Therefore, all these conditions are primarily treated with calming the spirit, using Anshen Wan and Jinbo Zhenxin Wan.

Language disorder is classified as delirium, often caused by loss of heart and spirit, as well as phlegm clouding the heart's openings, and is uniformly treated with Jinbo Zhenxin Wan. Rage and shouting are classified as mania, caused by fire-related disturbances, leading to confusion of the spirit and restlessness of the limbs, treated with Gun Tan Wan.

Ghost-seeing (1) is also a type of delirium. When the Yangming meridian is diseased and the stomach has dry feces, ghosts may appear in the eyes, requiring San Yi Chengqi Tang to remove them. For patients with blood loss, when blood stasis occurs internally, they may also experience delirium and ghost-seeing, as both are real pathogenic factors that disturb the clarity of vision, so Tao Ren Chengqi Tang is used for treatment.

[Note]

(1) Ghost-seeing: Article 217 of the "Shanghan Lun" states: "At dusk, a tidal fever occurs, without chills, speaking to oneself as if seeing ghosts... Da Chengqi Tang is the primary treatment."

[Commentary] Sleeplessness is considered a dream, indicating that the soul is uneasy; wakefulness is considered confusion, indicating that the spirit is uneasy. The former is treated with the liver, while the latter is treated with the lungs. Both soul and spirit are governed by the spirit, and both dreams and confusion can be treated with the heart, which highlights the similarities and differences between the two. Based on this, when treating confusion, attention should be paid to the heart and lungs, using Clear Metal Stabilize Spirit Soup, Clear Dryness Rescue Lung Soup, Di Po Soup, and Anshen Wan, applying cold and hot approaches accordingly. The "Jin Gui" Lily Disease shares some similarities with this condition, and treatment methods can be referenced accordingly.

Delirium is caused by phlegm clouding the heart's openings, mania is caused by phlegm and fire disturbing the heart, and ghost-seeing is caused by dry feces or blood stasis in the Yangming meridian. These three conditions can be treated with Jinbo Zhenxin Wan, Gun Tan Wan, San Yi Chengqi Tang, or Tao Ren Chengqi Tang, respectively.