Dizziness and Headache

Dizziness and Headache

In cases of typhoid fever and other miscellaneous illnesses, dizziness and headache are often caused by wind-cold. For patients with blood loss, dizziness and headache are often due to phlegm and fire, and improper use of dispersing medicines often exacerbates the condition.

When phlegm and qi surge upward, the head and eyes feel heavy and blurry, with a constant urge to vomit, as if the head is wrapped in something, the right-hand pulse is strong, and rainy weather worsens the pain—this is a phlegm symptom. Erchen Decoction with Fangfeng, Chuanxiong, Huangqin, Bohe, Xixin, and Shigao is used for treatment. For severe cases, Xiaohua Wan is used.

For those with fire-related dizziness and headache, they feel thirsty and drink more, the fire intensifies, turning the head even more painful, with bitter taste in the mouth, dry throat, red urine, and constipation, the left-hand pulse is rapid—this is a fire symptom. Da Chaihu Tang is used for treatment, along with Danggui Lu Hui Wan; for milder cases, Xiao Chaihu Tang with Chrysanthemum is sufficient.

All of the above are actual cases of dizziness and headache. There are also virtual cases of dizziness and headache, requiring separate classification into dizziness and headache categories, followed by different treatment approaches. Liver deficiency causes dizziness; the "Inner Canon" states: "All cases of dizziness and vertigo are related to the liver."(2) When liver blood is insufficient, wind arises, and wind is active, causing dizziness and vertigo. Patients with blood loss often experience wind-related dizziness, so Xiaoyao San with Chuanxiong, Qingzi, and Xiakucao is used for treatment. Alternatively, simply nourishing the liver to address the root cause of wind, using Zuogui Yin with Niuxi, Bajitian, Hangzhou Chrysanthemum, Xixin, and Goji berries. Kidney deficiency causes headache; the "Inner Canon" says: "Headaches are mostly caused by deficiencies in the lower part of the body and excesses in the upper part, with the problem lying in the Shaoyin meridian."(3) Liu Wei Di Huang Wan with Xixin, Congbai, and Musk is used for treatment. If it is a kidney-related headache, it means that turbid yin in the kidneys rises to the head, with the upper part being solid and the lower part being cold, and the hands and feet are icy cold, so Shenqi Wan with Xixin and Congbai is recommended. The pain in this case penetrates deep into the teeth and brain, unlike ordinary minor pains, and patients with blood loss rarely experience such headaches, so Liu Wei Wan is more commonly used. Again it is said: Although dizziness and headache are two separate conditions, in individuals with blood deficiency, both symptoms often appear together. Due to blood deficiency, wind stirs and causes vertigo, while fire stirs and causes fainting. I maintain that one should not differentiate between fainting and headache, nor should one distinguish between treating the liver or the kidney; instead, the general approach is to use Siwu Decoction combined with Yuanshen, Goji berries, Cistanche, Polygonatum, Gastrodia, Asarum, Anemarrhena, Phellodendron, Cornus fruit, and Achyranthes root.

[Note]

(1) Wùwù: A state of depression and restlessness.

(2) See "Plain Questions · The Great Discussion on Supreme Truth."

(3) See "Plain Questions · The Chapter on the Generation of the Five Zang Organs."

[Commentary] This section emphasizes that in cases of dizziness and headache due to blood deficiency, phlegm and fire are often predominant, and one must avoid mistakenly using methods that induce sweating. This condition can be divided into two types: deficiency and excess. For excess cases of dizziness and headache, if the left-hand pulse is full, it indicates phlegm-qi attacking and surging, and Erchen Decoction combined with Fangfeng, Chuanxiong, and Asarum is appropriate; if the right-hand pulse is rapid, it indicates liver fire rising upward, and Dachaihu Decoction, Danggui Luhui Pill, or Xiaochaihu Decoction combined with Chrysanthemum are suitable. For deficiency cases of dizziness and headache, if it is dizziness, treat the liver with Xiaoyao Powder combined with Chuanxiong, Qingzi, and Prunella; if it is pain, treat the kidney with Liuwei Pills combined with Asarum, White Onion, and Musk. In cases of dizziness and headache due to blood loss, the general treatment is Siwu Decoction combined with Yuanshen, Goji berries, Cistanche, and Polygonatum, because the liver and kidney share a common origin, and after blood loss, both organs often require simultaneous treatment.