Hydrocephalus in Traditional Chinese Medicine
Understanding different hydrocephalus patterns according to TCM theory
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Condition Categories
Condition Categories
Hydrocephalus, commonly referred to as “water on the brain”, is a condition characterized by an abnormal accumulation of cerebrospinal fluid (CSF) within the ventricles, or cavities, of the brain.
This accumulation can increase intracranial pressure and lead to swelling of the head, potentially impairing brain function. Hydrocephalus can be congenital or acquired and may present in infants, children, or adults. The condition requires careful medical evaluation to manage the symptoms and prevent long-term neurological damage.
In the framework of Traditional Chinese Medicine (TCM), hydrocephalus is understood as a manifestation of an imbalance within the body’s fundamental substances, particularly concerning the flow of Jin Ye (Body Fluids).
TCM does not view hydrocephalus as merely a localized issue but rather as a symptom of underlying systemic disharmony. It's believed that factors such as Kidney Essence Deficiency or Spleen Qi not managing fluids properly can lead to the pathological accumulation of fluid. Identifying the correct pattern behind the symptoms is essential for TCM practitioners to provide an effective treatment plan.
TCM Patterns for Hydrocephalus
Each pattern represents a distinct underlying imbalance that can cause hydrocephalus
Spleen Deficiency with Dampness
Diagnostic signs
Soggy (Ru), Slowed-down (Huan), Slippery (Hua), Deep (Chen)
The tongue is characteristically pale and swollen, often appearing puffy and tender, with clear teeth marks indented along both edges. The coating is white and greasy (or thick and greasy in more pronounced cases), reflecting the accumulation of Dampness in the Middle Burner. The tongue surface is typically moist or even excessively wet. In some cases, the coating may be slightly slippery. If the Dampness is particularly heavy, the coating may appear thick and white across the entire tongue body, sometimes most prominent in the centre (corresponding to the Spleen and Stomach area).
Phlegm in the Lower Burner
Diagnostic signs
Slippery (Hua), Deep (Chen), Slow (Chi), Wiry (Xian)
The tongue is characteristically pale and swollen, often with teeth marks along the edges from pressing against the teeth, indicating fluid accumulation. The coating is notably thick, white, and greasy, particularly at the root (back portion) of the tongue, which corresponds to the Lower Burner. The entire tongue surface tends to appear wet or slippery. In some cases the coating may extend thicker toward the centre and rear while being thinner at the front, reflecting that the pathological material is concentrated in the lower and middle parts of the body.
Phlegm
Diagnostic signs
Slippery (Hua), Wiry (Xian)
The classic Phlegm tongue is swollen and pale with tooth marks along the edges, reflecting the Spleen's inability to properly manage fluids. The coating is the most diagnostic feature: it is characteristically white, thick, and greasy or sticky, indicating the presence of turbid Phlegm and Dampness. The tongue body is typically moist to wet. If Phlegm begins to transform with Heat, the coating may turn yellowish and greasy, but in the base pattern the coating remains white. The tongue body itself is not red or purple, distinguishing this from Phlegm-Heat or Phlegm with Blood Stasis transformations.
Herbal Formulas for Hydrocephalus
Traditional Chinese Medicine formulas used to address hydrocephalus