Pediatric Tourette’s Syndrome Case

While on the topic of Gan Mai Da Zao Tang‘s use in pediatrics, here’s another interesting case.

Pediatric Tourette’s syndrome

The patient was an 8-year-old boy who came for a consult on January 5^th, 2005.  He frequently blinked his eyes and moved his mouth.  This had gone on for more than ½ a year.  This began after a common cold.  He blinked and moved his mouth, furrowed his brow and was easily agitated.  He was often angry and had to move about a lot.  When this was extreme he would speak wildly, hit people and destroy objects.  He had undergone western medical treatment but the diagnosis and treatment history is not clear, but the effect was not evident.  At the time of his consultation, he was blinking, furrowing his brow and moving his mouth a lot.  He was clearly agitated.  His speech was full of curses and obscenities.  His appetite and bowels were fine.  His urine was reddish yellow.  His pulses were wiry and thin.  The electroencephalogram was slightly abnormal.  He was given 3 packages of Gan Mai Da Zao Tang with the following herbs:

This was decocted in water, one package for one day.

Second visit:  His disposition had changed for the better.  The blinking had decreased but the mouth movements were still frequent.  I gave 7 packages of the previous formula and added 18 gm Fu Xiao Mai, 8 gm Chuan Mu Gua and 8 gm Bai Shao.

Third visit:  All of the above symptoms had changed for the better.  I continued with the same formula with additions and subtractions for 3 months and all the symptoms dispersed.

Discussion: For children’s bodies, the Yang is relatively exuberant and the Yin is relatively insufficient.  The liver and the heart often have enough to spare.  It is easy for the heart fire to blaze.  When the liver Yang is over exuberant, it causes the manifestation of wind movement and can cause twitching.  When the heart Yang is over abundant, it causes the manifestation of movement and lack of peace.  “Tourette’s syndrome” root source is in the liver.  The liver is categorized as wood.  It is the Shao Yang ministerial fire.  The heart governs the spirit brightness and is the sovereign fire.  It governs the blood, speech and laughter.  The author considers that this illness easily expands to the heart.  This is the mother’s illness (wood) as well as the child (fire).  In terms of treatment, both the liver and heart should be treated together.  The chief of Gan Mai Da Zao Tang is Xiao Mai.  It has a sweet cold nature, nourishing the liver, supplementing the heart and calming the spirit mind.   Zhi Gan Cao is sweet and neutral.  It supplements and nourishes the heart Qi, harmonizes the middle and relaxes spasming.  It is the minister herb.  Da Zao is sweet and warm.  It has a soft moist body.  It boosts the Qi, harmonizes the middle, moistens dryness, and relaxes spasming.  It is an assistant herb.  These three herbs are combined together to sweetly moisten, enrich and supplement.  They nourish the heart, calm the spirit, emolliate the liver and relax spasming.  This formula is constructed to aim directly at the distinctive characteristics of the disease mechanism.  Blood is categorized as Yin and so Si Wu Tang was added.  This formula supplements blood and harmonizes blood.  There is the saying that “to treat wind, you treat the blood.  When blood moves, the wind spontaneously leaves.”   Gou Teng, Chan Tui and Bai Shao eliminate wind and stop spasming.  Chuan Mu Gua vitalizes the Luo vessels and stops twitching.  Because there were additions and subtractions that corresponded to the disease, results were obtained.