Medical History: This patient is a 24-year old woman who has periods of uncontrollable laughter for two years. She was in a very bad car accident two years ago, and since that time has been easily startles or “jumpy” and had laughing spells that she is unable to stop. The laughter is worse when she feels overwhelmed. She describes the laughter as a sensation of stress in her chest which moves to her throat and then comes out as laughter. The patient reports that she can partially control the laughter by thinking peaceful thoughts.
Symptoms: Along with the laughter, this patient complains of Plum Pit Qi, or a lump in her throat. She feels hot and wakes up each morning sweating. She is thirsty and needs to drink cold water. The patient has difficulty getting to sleep because her mind is racing, and wakes occasionally, but usually can get back to sleep. She complains of chest tightness, heart palpitations, and has a lot of phlegm which causes her to frequently clear her throat. She feels nausea when she is hungry.
Pulse and Palpation: This patient’s pulse was deep and irregular, with missed beats.
Tongue and Observation: The tongue was light red with a red tip, swollen, and had a thick greasy coating. This patient had a difficult time controlling her laughter during the initial treatment.
OM Diagnosis: Phlegm heat disturbing the Heart.
Point Prescription: Yin Tang and Ear Shen Men to calm the Shen.
Ht 7 to calm the Heart, for insomnia and anxiety.
P6 to calm the Heart, address the middle burner, and for Plum Pit Qi.
LI 11 to clear heat.
St 40 to resolve phlegm.
Liv 3 to calm the mind and for insomnia.
Herb Prescription: Patient initially declined herbs, however after the heat symptoms and laughter had resolved, the Plum Pit Qi remained. At that time the patient took Ban Xia Hou Po Wan.
Lifestyle Prescription: Calcium supplements to help calm the Shen, B complex supplement to help with stress. Gave the patient lists of foods to resolve phlegm and damp, as well as foods to avoid.
Results: After the first treatment, the patient reported that she felt calmer and the laughter was 50-60% improved. She also reported that the feeling of heat was gone. However, the tightness in her chest and the Plum Pit Qi still remained at the third treatment, at which time herbs were prescribed. By the 4th and 5th treatments, the Plum Pit Qi was almost completely gone, and the patient reported that she had only one or two minor episodes of giggling during the previous month
Synopsis: This young woman’s pattern was brought on by the traumatic nature of her car accident two years ago. The accident was a shock which created a Shen disturbance and caused Qi stagnation, which ultimately engendered phlegm and heat. The manifestation of this pattern was a kind of mania (uncontrollable laughter)
as well as Plum Pit Qi. Because this patient was young and otherwise healthy, she responded quickly to the acupuncture and herbal formula.
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