眩晕3(高血压)
严某某，男，36岁
初诊
眩晕头痛经常发作，脉象弦滑有力，按之急数且搏指，舌红苔白根厚。大便干结，心烦易怒，素嗜烟酒，又多熬夜，为本病致病之由。此肝阳上亢，木火上升，先以熄风折热方法。
白蒺藜10克，晚蚕砂10克，蔓剂子10克，勾藤10克，菊花10克，竹茹6克，陈皮10克，生石决明20克，生牡蛎20
克，瓜蒌仁20克，焦三仙各10克，七剂
二诊
药后头痛已止，眩晕时或发生。脉仍弦滑，按之有力，舌红苔白根部仍较厚。大便通而未畅。风阳上扰之势虽缓，然病非一日所成，须得慎饮食、戒烟酒，节喜怒，方为根本之计，不可徒赖药物也。仍用前法加减。
白蒺藜10克，晚蚕砂10克，赤白芍各10克，勾藤10克，菊花10克，竹叶茹各6克，生石决明20克，生牡蛎20克，焦三仙各10克，水红花子10克，七剂
上方服后头痛眩晕皆止，二便如常。睡眠亦安。遂嘱其注意饮食调理，增加运动锻炼，以防复发。
[按]：本案之眩晕是属肝胆风热上扰，良由过嗜烟酒，加之敖夜所致。因其兼有头痛，故用白蒺藜、晚蚕砂、蔓剂子以清头目；勾藤、菊花以熄风阳；阳亢于上者宜用介类以潜之，故用生石决明，生牡蛎以镇潜；风阳上扰多挟痰热，故用竹茹，陈皮以化痰热；从舌苔根厚大便干结，知其三焦壅滞，故用瓜蒌仁、
118
焦三仙咀利三焦。用药恰合病机，故服之即效。而医嘱其慎饮食、戒烟酒、多运动，尤为金玉良言，切中其病根矣。若患者果能实行之，则一生受益可知也。
眩晕4(高血压)
冉某某，男，61岁
初诊
头晕目眩，面红目赤，唇紫且干，舌红起刺，苔垢而厚，两脉弦滑有力，按之振指，愈按愈盛，血压180／l00mmHg，病已三十余年，一向服西药心痛定、复方降压片维持。近因动怒，血压剧增，服药无济于事，夜寐梦多，阵阵烦急。此木郁化火，肝阳上亢，急以镇潜息风，活血化瘀方法，须防中风之变。
生石决明20克，生牡蛎20克，珍珠母20克，菊花10克，桑叶10克，勾藤10克(后下)，赤芍10克，丹参10克，茅芦根各10克，牛膝10克，黄芩10克，山栀6克，七剂。
二诊
药后眩晕稍臧，夜能成寐，脉仍弦滑有力，舌红苔白根厚，术火仍炽，仍用前法加减。
生石决明20克，生牡蛎20克，珍珠母20克，勾藤10克，赤白芍各10克，龙胆草3克，夏枯草10克，丹参10克，茜草10克，黄芩10克，川楝子10克，七剂。
三诊
两进清泄肝胆镇潜息风之剂，木火已减，风阳暂息，眩晕之势大缓，夜寐亦得安稳，诊脉弦滑，沉取弦细，舌红苔白，前法继进，再增入滋填，以救肾水，为治本之法。
119
生熟地黄各20克，女贞子10克，旱莲草10克，生石决明20克，生牡蛎20克，珍珠母20克，勾藤10克(后下)，桑叶10
克，菊花10克，丹参10克，赤白芍各10克，牛膝10克，七剂
上方服后，眩晕已止，食眠如常，血压稳定在140～150／85～90mmHg之间。嘱其素食、忌辛辣，戒烟酒，节喜怒，以巩固疗效。
[按]：此案患者年老病久，顽固的高血压眩晕，辨为肝阳化风，木火上升，故用药镇潜与清泄并重，又因其老年动脉硬化，故用活血化瘀之品，贯彻始终。风阳得息，木火已减之后，又增入滋肾壮水之味，用生熟地、二至丸之类以滋肾水之不足为治本之计。急则治其标，缓则治其本，此之谓也。
眩晕5(美尼尔氏综合征)
蔺某，女，51岁
初诊
突发眩晕，不能起坐，恶心欲吐，心悸不安，自觉胃中漉漉有声。舌白滑润，舌体胖大，边有齿痕，脉象孺滑而沉，一派水饮上泛之象，先用苓桂术甘汤方法，以消饮定眩。
桂枝10克，茯苓15克，白术12克，炙甘草6克，半夏10克，陈皮6克，泽泻10克，三剂
二诊
眩晕渐减，心悸稍安，胸闷恶心未除。脉沉濡，舌白润，仲师云：病水饮者当以温药和之。继用前法增损。
桂枝10克，茯苓20克，白术12克，炙草6克，干姜3克，半夏10克，陈皮10克，泽泻10克，焦三仙各10克，三剂
1 20
三诊
眩晕已止，诸证渐安，已能下地活动，微感胸闷，纳食欠佳，舌白脉沉，用《外合》茯苓饮以运中阳。
茯苓15克，白术10克，桂枝6克，枳实6克，厚朴6克，白蔻仁3克，焦三仙各10克，三剂
药后诸症皆安，停药休息数日而痊。
[按]；此案眩晕系饮邪上泛，蒙蔽清阳，其脉沉苔滑，口不渴，胸闷呕恶，水声漉漉，皆是水饮之征，故用苓桂术甘汤以化饮定眩定悸，二诊加干姜，焦三仙以运中阳，阳气振奋则水饮自消，三诊用《外合》茯苓饮加味以消余邪，大法治饮宗仲景以温药和之之旨，治在中焦，以脾属土，饮乃水类，土能制水，脾健则饮自消弥。
眩晕6(脑动脉硬化)
乔某某，男，61岁
初诊
头目眩晕经常发作，双耳鸣响如蝉，心中儋憎悸动不安，舌淡胖，脉象沉弱，下元不足，下虚则上实，故发为眩晕耳鸣，姑拟填补下元方法。
熟地黄10克，山萸内10克，枸杞子10克，补骨脂10克，生牡蛎20克，杜仲10克，川续断10克，菟丝子10克，生石决明20克，楮实子10克，七剂
二诊
药后眩晕略减，耳鸣如前，精亏日久，不能上承于脑，髓海空虚故脑转耳鸣，失眠健忘继进填补之剂。，
121
熟地黄10克，山萸肉10克，枸杞子10克，补骨脂10克，杜仲10克，川续断10克，制首乌10克，楮实子10克，桑椹子10克，焦三仙各10克，十剂
三诊
上方服10剂之后，患者自觉效佳，又按原方购10剂。眩晕心悸显著减轻，耳鸣也减轻不步，精力较前为强。填补之治，非日久不能见功，姑拟丸方，以为长久之计。
熟地黄60克，山萸肉60克，枸杞子60克，补骨脂30克，杜仲60克，川续断30克，菟丝子60克，桑椹子60克，楮实子60克，焦三仙各30克，白术30克，党参60克，黄芪60克，当归30克，茯苓60克，丹参60克。
上药共为细末，炼蜜为丸，每丸重10克，每日早午晚各服一丸，白开水送下，遇感冒停服。
上药服完一料后，自觉精力有加，眩晕等症皆除。
[按]：此案眩晕属虚，脉舌色症，皆为虚象，故治以填补方法。虚证的平复非一朝一夕之功。故在见效之后，处以丸药。
丸药方中，除以填补下元为主体之外，并从后天调治，故用参、芪、当归、苓、术等品，并加焦三仙以助运化，这样先后天并补，中下兼顾，方可常服以图缓效。
眩晕7(高血脂萌臁硬化)
鲁某某，男，56岁
初诊
弦晕经常发生，形体肥胖，体重逾200斤，面色红赤，油光满面，口臭便干，大便7、8甘一行，舌黄垢厚，脉象弦滑，按之
122
力盛。此平日恣食高粱厚味，致痰食积滞互阻肠胃，三焦不畅，升降失司，痰阻经络，日久必有中风之虞。西医检查确诊为高血脂、动脉硬化，正与中医之痰热瘀滞相合。先用消导化痰方法。
莱菔子10克，大腹皮子各10克，苏子10克，白芥子6
克，皂角6克，水红花子10克，焦三仙各10克，大黄6克，牛膝10克，七剂
二诊
药后大便畅通，头晕已减，夜寐渐安，心中舒适。舌苔渐化，脉仍弦滑，痰瘀互结，非一日可除。须得节饮食，戒厚味，经常运动锻炼，方为根本之策。否则，徒赖药物无益也。前法进退。
莱菔子10克，苏子10克，白芥子6克，冬瓜子10克，皂角子6克，水红花子10克，大腹皮子各10克，焦三仙各10
克，丹参10克，茜草10克，茅芦根各10克，大黄6克，10剂。
三诊
患者按上方坚持服药1个月，并遵医嘱实行节食，基本素食，并加强运动锻炼，每目步行2～3小时，体重减轻10余斤，行动较前敏捷，头已不晕，精力增加，自觉有年轻之感。遂嘱其停药，以运动锻炼为主，并合理安排饮食，素食为主。
[按]：凡形伟体肥，脉象弦滑有力者，大多属痰瘀互结，可表现为眩晕、麻木、疼痛等不同症状，其病机为痰浊阻滞经络，治以涤痰通络。赵师常用三子养亲汤加入冬瓜子，皂角子，名五子涤痰汤，大能去痰通络，再合大腹皮子、水红花子，焦三仙等疏调三焦，便干结者必用大黄通之；若肢体麻木疼痛，可加丝瓜络、桑枝等通络之品；血中瘀滞，可加丹参、茜草、赤芍、牛
123
膝等；果有下元不足，表现为上盛下虚者，可加杜仲、川续断、补骨脂。而用诸子涤痰则为必用之法，乃赵师治痰之心法也。
头痛1(神经性头痛
章某某，女，47岁
初诊
头痛经常发作，每于经前加剧，癸事色深成块。舌红且千，心烦急躁，脉象弦滑而数，大便干结，小便黄赤。血虚肝阳上亢，虚热上扰，故经前头痛发作，癸事色深成块，血分瘀热也。
用凉血化瘀，兼折其热，养阴息风，治在八脉。
益母草10克，赤芍10克，丹参10克，茜草10克，炒山栀6克，柴胡6克，生地黄10克，元参10克，麦冬10克，大黄1
克，七剂
二诊
癸事适来，头痛较前显著减轻。经色鲜红，结块减少。脉数舌红，血分郁热尚未全清，再以前法进退。
益母草10在，泽兰叶10克，赤芍10克，丹参10克，茜草10克，柴胡6克，黄芩10克，川檩子10克，生地黄10克，玄参10克，七剂
三诊
药后自觉舒适，头痛未作，夜寐向安，食饮如常。舌红苔白，脉象濡精，按之小数。肝热已解，再以养血育阴方法。
生地黄10克，赤白芍各10克，女贞子10克，旱莲草10
克，柴胡6克，黄芩10克，川楝子10克，丹参10克，茜草10
克，益母草10克，10剂
124
以上方加减服至下次月经来潮，头痛未再发生，经色、量，质均属正常，病告痊愈。
[按]：本案患者头痛发生于经前，结合经色探有块，知其为血分瘀热。而肝为血海，为女子之先天，血热肝必旺，故知其肝阳上亢，心烦易怒，夜寐梦多，诸证不免矣。妇女此种头痛者甚多，治疗当从调经入手，泻其血分瘀热，用凉血化瘀方法。故方中并未有一味专治头痛的药，只是泄肝热，凉血热，活密滞。
随着血热渐除，月经复常，头痛自然面愈。故中医治病并非见症治症，而是辨证求因，审因论治。三诊时患者血热已解，肝热亦平，即改用养血育阴为主，阴充血足，肝体得养，则癸事如常，而无头痛之患矣。
头痛2(神经性头痛)
余某某，女，50岁头痛10余年，经常发作，痛时连及目珠作胀，必服止痛片方止。近几年来每日必服头痛粉一二包，否则头痛不能自支。寡居20余年，情志不遂，郁火内生，木火上扰，而作头痛，常理虽然如此，然前服清热养阴，凉血息风之剂，皆未能见效。诊其脉来力弱，舌白且润，并无热象可据。且头为诸阳之会，三阳经脉皆上于头，经云清阳出上窍，乃得耳聪耳明，今清阳不主上升，浊阴反犯于上，久则络脉痹阻。故尔头痛不止。议用升清阳活血通络方法。
川芎30克，茺蔚子30克
上二味为一剂，煎汤代茶，饮不拘时。
患者服上方代茶饮后，头痛即止。
[按]：此头痛日久不愈，按病久入络对待，川芎活血行
125
Vertigo 3 (Hypertension)
Yan XX, Male, 36 years old
First Visit
Vertigo and headache occur frequently. The pulse is wiry, slippery, and forceful; upon deep pressure, it feels rapid and beats against the finger. The tongue body is red with a white coating that is thick at the root. Stool is dry and constipated; there is mental restlessness and irritability. A history of heavy smoking and alcohol consumption, along with frequent staying up late, are the causes of this disease. This is Liver Yang rising and Liver Fire ascending. Initially, use methods to extinguish wind and reduce heat.
Tribulus Terrestris Fruit (Baijili) 10g, Mulberry Sand (Wancansha) 10g, Vitex Fruit (Manjingzi) 10g, Uncaria Ramulus cum Uncis (Gouteng) 10g, Chrysanthemum Flower (Juhua) 10g, Bamboo Shavings (Zhuru) 6g, Tangerine Peel (Chenpi) 10g, Prepared Concha Arcae (Sheng Shijueming) 20g, Prepared Ostrea Shell (Sheng Muli) 20g, Trichosanthis Semen (Gualouren) 20g, Scoriae Fructus Glycines et Radix Paeoniae Rubrae et Radix Achyranthis Bidentatae (Jiao Sanxian) 10g each, 7 doses.
Second Visit
After taking the medicine, the headache has stopped, but vertigo occurs occasionally. The pulse remains wiry and slippery, forceful upon deep pressure. The tongue body is red with a white coating, still thick at the root. Bowel movement is patent but not smooth. Although the trend of Wind-Yang disturbing upwards has slowed, the disease did not form in one day. One must be cautious with diet, quit smoking and alcohol, and regulate emotions; this is the fundamental plan, and one cannot rely solely on medication. Continue with modifications of the previous method.
Tribulus Terrestris Fruit (Baijili) 10g, Mulberry Sand (Wancansha) 10g, Red Peony Root (Chishao) and White Peony Root (Baishao) 10g each, Uncaria Ramulus cum Uncis (Gouteng) 10g, Chrysanthemum Flower (Juhua) 10g, Bamboo Leaf (Zhuyeqi) and Bamboo Shavings (Zhuru) 6g each, Prepared Concha Arcae (Sheng Shijueming) 20g, Prepared Ostrea Shell (Sheng Muli) 20g, Jiao Sanxian 10g each, Polygonum Orientale Fruit (Shuihonghuazi) 10g, 7 doses.
After taking the above prescription, both headache and vertigo ceased, bowel and bladder functions were normal, and sleep was peaceful. He was advised to pay attention to dietary regulation and increase exercise to prevent recurrence.
[Commentary]: The vertigo in this case belongs to Wind-Heat of the Liver and Gallbladder disturbing upwards, primarily caused by excessive smoking and alcohol consumption, combined with staying up late. Because it is accompanied by headache, Tribulus Terrestris Fruit, Mulberry Sand, and Vitex Fruit are used to clear the head and eyes; Uncaria Ramulus cum Uncis and Chrysanthemum Flower are used to extinguish Wind-Yang; for Yang hyperactivity above, shell-type minerals are suitable for subduing, so Prepared Concha Arcae and Prepared Ostrea Shell are used to anchor and subdue; Wind-Yang disturbing upwards often carries Phlegm-Heat, so Bamboo Shavings and Tangerine Peel are used to resolve Phlegm-Heat; from the thick root coating and dry stool, it is known that the Triple Burner is obstructed, so Trichosanthis Semen and Jiao Sanxian are used to unblock the Triple Burner. The medication precisely matches the pathogenesis, hence immediate effect. The medical advice to be cautious with diet, quit smoking and alcohol, and exercise more is golden wisdom, hitting the root of the disease. If the patient truly implements this, he will benefit for life.
Vertigo 4 (Hypertension)
Ran XX, Male, 61 years old
First Visit
Dizziness and vertigo, red face and red eyes, purple and dry lips, red tongue with prickles, dirty and thick coating, bilateral pulses wiry and slippery and forceful, vibrating under pressure, becoming stronger with deeper pressure. Blood pressure 180/100 mmHg. The illness has lasted over thirty years, maintained by Western medicines Nifedipine and Compound降压 Tablets. Recently, due to anger, blood pressure surged dramatically, and medication was ineffective. Sleep is disturbed with many dreams, and there are episodes of irritability and anxiety. This is Liver Qi stagnation transforming into Fire, with Liver Yang hyperactivity. Urgently apply methods to anchor, subdue, extinguish wind, and invigorate blood to remove stasis. Beware of stroke complications.
Prepared Concha Arcae (Sheng Shijueming) 20g, Prepared Ostrea Shell (Sheng Muli) 20g, Mother-of-Pearl Shell (Zhenzhumu) 20g, Chrysanthemum Flower (Juhua) 10g, Mulberry Leaf (Sangye) 10g, Uncaria Ramulus cum Uncis (Gouteng) 10g (added later), Red Peony Root (Chishao) 10g, Salvia Root (Danshen) 10g, Imperata Rhizome (Maogen) and Reed Rhizome (Lugen) 10g each, Achyranthes Root (Niuxi) 10g, Scutellaria Root (Huangqin) 10g, Gardenia Fruit (Shanzhi) 6g, 7 doses.
Second Visit
After medication, vertigo slightly decreased, and night sleep improved. The pulse remains wiry, slippery, and forceful. The tongue is red with a white coating thick at the root. Liver Fire is still blazing. Continue with modifications of the previous method.
Prepared Concha Arcae (Sheng Shijueming) 20g, Prepared Ostrea Shell (Sheng Muli) 20g, Mother-of-Pearl Shell (Zhenzhumu) 20g, Uncaria Ramulus cum Uncis (Gouteng) 10g, Red Peony Root (Chishao) and White Peony Root (Baishao) 10g each, Gentian Root (Longdancao) 3g, Prunella Spike (Xiakucao) 10g, Salvia Root (Danshen) 10g, Rubia Root (Qiancao) 10g, Scutellaria Root (Huangqin) 10g, Toosendan Fruit (Chuanlianzi) 10g, 7 doses.
Third Visit
After two courses of clearing and draining Liver/Gallbladder, anchoring/subduing, and extinguishing wind, Liver Fire has decreased, and Wind-Yang has temporarily subsided. The trend of vertigo has greatly slowed, and night sleep is stable. The pulse is wiry and slippery; deep palpation reveals wiry and fine qualities. The tongue is red with a white coating. Continue the previous method, adding nourishing and filling methods to rescue Kidney Water, which is the treatment for the root.
Raw and Prepared Rehmannia Root (Sheng/Shu Dihuang) 20g each, Lycium Fruit (Gouqizi) 10g, Ligustrum Fruit (Nvzhenzi) 10g, Eclipta Herb (Hanliancao) 10g, Prepared Concha Arcae (Sheng Shijueming) 20g, Prepared Ostrea Shell (Sheng Muli) 20g, Mother-of-Pearl Shell (Zhenzhumu) 20g, Uncaria Ramulus cum Uncis (Gouteng) 10g (added later), Mulberry Leaf (Sangye) 10g, Chrysanthemum Flower (Juhua) 10g, Salvia Root (Danshen) 10g, Red Peony Root (Chishao) and White Peony Root (Baishao) 10g each, Achyranthes Root (Niuxi) 10g, 7 doses.
After taking the above prescription, vertigo ceased, appetite and sleep returned to normal, and blood pressure stabilized between 140-150/85-90 mmHg. Advised vegetarian diet, avoid spicy foods, quit smoking and alcohol, and regulate emotions to consolidate efficacy.
[Commentary]: The patient is elderly with a long-standing illness of stubborn hypertensive vertigo. It is differentiated as Liver Yang transforming into Wind and Wood-Fire ascending. Therefore, anchoring/subduing and clearing/draining are emphasized equally. Due to arteriosclerosis in the elderly, blood-invigorating and stasis-removing herbs are used throughout. After Wind-Yang subsides and Liver Fire decreases, Kidney-nourishing and Water-enriching herbs are added, such as Raw/Prepared Rehmannia Root and Er Zhi Wan, to treat the root by replenishing insufficient Kidney Water. "In acute cases, treat the branch; in chronic cases, treat the root." This is what is meant.
Vertigo 5 (Meniere's Disease)
Lin XX, Female, 51 years old
First Visit
Sudden onset of vertigo, inability to sit or stand, nausea with urge to vomit, palpitations and unrest, sensation of gurgling water sounds in the stomach. Tongue coating is white, slippery, and moist; tongue body is fat and large with teeth marks on the edges. Pulse is soggy, slippery, and deep. This presents a picture of Fluid Retention surging upwards. Initially use Ling Gui Zhu Gan Tang method to eliminate Fluids and settle vertigo.
Cinnamon Twig (Guizhi) 10g, Poria (Fuling) 15g, Atractylodes Macrocephala Rhizome (Baizhu) 12g, Prepared Licorice Root (Zhi Gancao) 6g, Pinellia Tuber (Banxia) 10g, Tangerine Peel (Chenpi) 6g, Alisma Rhizome (Zexie) 10g, 3 doses.
Second Visit
Vertigo gradually decreased, palpitations slightly calmed, but chest tightness and nausea remained. Pulse is deep and soggy; tongue coating is white and moist. Master Zhongjing said: "For diseases of Fluid Retention, warm herbs should be used to harmonize." Continue with modifications of the previous method.
Cinnamon Twig (Guizhi) 10g, Poria (Fuling) 20g, Atractylodes Macrocephala Rhizome (Baizhu) 12g, Prepared Licorice Root (Zhi Gancao) 6g, Dried Ginger (Ganjiang) 3g, Pinellia Tuber (Banxia) 10g, Tangerine Peel (Chenpi) 10g, Alisma Rhizome (Zexie) 10g, Jiao Sanxian 10g each, 3 doses.
Third Visit
Vertigo has ceased, other symptoms have gradually stabilized, able to get out of bed and move. Slight chest tightness remains, poor appetite. Tongue coating is white, pulse is deep. Use Wuling Yin from *Waitai Miyao* to transform Middle Jiao Yang.
Poria (Fuling) 15g, Atractylodes Macrocephala Rhizome (Baizhu) 10g, Cinnamon Twig (Guizhi) 6g, Immature Bitter Orange (Zhishi) 6g, Magnolia Bark (Houpo) 6g, White Cardamom Seed (Baokouren) 3g, Jiao Sanxian 10g each, 3 doses.
After medication, all symptoms resolved. Rested for a few days after stopping medication and recovered.
[Commentary]: This vertigo is caused by Pathogenic Fluids surging upwards and obscuring Clear Yang. Deep pulse, slippery coating, no thirst, chest tightness, vomiting, and gurgling water sounds are all signs of Fluid Retention. Thus, Ling Gui Zhu Gan Tang is used to transform Fluids, settle vertigo, and calm palpitations. In the second visit, Dried Ginger and Jiao Sanxian are added to transform Middle Jiao Yang; when Yang Qi is revitalized, Fluids dissipate naturally. In the third visit, modified Wuling Yin is used to eliminate residual pathogens. The general principle for treating Fluids follows Zhang Zhongjing's doctrine of using warm herbs to harmonize, focusing on the Middle Jiao. Since Spleen belongs to Earth and Fluids belong to Water, Earth controls Water; when Spleen is healthy, Fluids are eliminated.
Vertigo 6 (Cerebral Arteriosclerosis)
Qiao XX, Male, 61 years old
First Visit
Frequent episodes of dizziness and vertigo, tinnitus in both ears like cicadas, palpitations and unrest in the heart. Tongue is pale and fat; pulse is deep and weak. Deficiency of the Lower Yuan (Kidney Essence). Lower deficiency leads to Upper excess, causing vertigo and tinnitus. Tentatively prescribe methods to tonify and fill the Lower Yuan.
Prepared Rehmannia Root (Shu Dihuang) 10g, Cornus Fruit (Shanyuzhuyu) 10g, Lycium Fruit (Gouqizi) 10g, Psoralea Fruit (Buguzhi) 10g, Prepared Ostrea Shell (Sheng Muli) 20g, Eucommia Bark (Duzhong) 10g, Cyathula Root (Chuanduxuan) 10g, Dodder Seed (Tusizi) 10g, Prepared Concha Arcae (Sheng Shijueming) 20g, Broussonetia Fruit (Chushizi) 10g, 7 doses.
Second Visit
Vertigo slightly reduced after medication, tinnitus persists. Long-term Essence deficiency cannot ascend to nourish the brain; emptiness of the Marrow Sea causes dizziness and tinnitus. Insomnia and memory loss continue. Proceed with tonifying and filling prescriptions.
Prepared Rehmannia Root (Shu Dihuang) 10g, Cornus Fruit (Shanyuzhuyu) 10g, Lycium Fruit (Gouqizi) 10g, Psoralea Fruit (Buguzhi) 10g, Eucommia Bark (Duzhong) 10g, Cyathula Root (Chuanduxuan) 10g, Prepared Fleeceflower Root (Zhi Shouwu) 10g, Broussonetia Fruit (Chushizi) 10g, Mulberry Fruit (Sangshenzi) 10g, Jiao Sanxian 10g each, 10 doses.
Third Visit
After taking the above prescription for 10 doses, the patient felt significant improvement and purchased another 10 doses according to the original formula. Vertigo and palpitations significantly reduced, tinnitus also decreased considerably, energy is stronger than before. Tonifying treatments take time to show results. Tentatively prepare a Pill Formula for long-term management.
Prepared Rehmannia Root (Shu Dihuang) 60g, Cornus Fruit (Shanyuzhuyu) 60g, Lycium Fruit (Gouqizi) 60g, Psoralea Fruit (Buguzhi) 30g, Eucommia Bark (Duzhong) 60g, Cyathula Root (Chuanduxuan) 30g, Dodder Seed (Tusizi) 60g, Mulberry Fruit (Sangshenzi) 60g, Broussonetia Fruit (Chushizi) 60g, Jiao Sanxian 30g each, Atractylodes Macrocephala Rhizome (Baizhu) 30g, Codonopsis Root (Dangshen) 60g, Astragalus Root (Huangqi) 60g, Angelica Sinensis Root (Danggui) 30g, Poria (Fuling) 60g, Salvia Root (Danshen) 60g.
Grind all herbs into fine powder, make pills with refined honey. Each pill weighs 10g. Take one pill morning, noon, and evening with plain boiled water. Stop during colds.
After finishing one course, energy increased significantly, and vertigo and other symptoms disappeared.
[Commentary]: This vertigo belongs to Deficiency patterns. Pulse, tongue, color, and symptoms all indicate deficiency, so treatment uses tonifying and filling methods. Recovery from deficiency takes time. Therefore, pills are prescribed after initial improvement.
The Pill Formula focuses on tonifying the Lower Yuan but also regulates the Post-Heaven (Spleen/Stomach) using Codonopsis, Astragalus, Angelica Sinensis, Poria, and Atractylodes, plus Jiao Sanxian to aid digestion. This tonifies both Pre-Heaven and Post-Heaven, addressing Middle and Lower Jiao simultaneously, allowing for long-term administration for gradual effect.
Vertigo 7 (Hyperlipidemia, Arteriosclerosis)
Lu XX, Male, 56 years old
First Visit
Frequent vertigo. Obese physique, weight over 200 jin (approx. 100kg). Red face, oily complexion, bad breath, dry stool, bowel movement once every 7-8 days. Tongue coating is yellow, dirty, and thick. Pulse is wiry and slippery, very forceful upon deep pressure. This is due to habitual indulgence in rich and greasy foods, leading to accumulation of Phlegm and Food stagnation obstructing the intestines and stomach, blocking the Triple Burner, disrupting ascending and descending functions, Phlegm obstructing collaterals. Long-term, there is risk of stroke. Western diagnosis confirms Hyperlipidemia and Arteriosclerosis, corresponding to TCM Phlegm-Heat and Blood Stasis obstruction. Initially use methods to promote digestion and resolve Phlegm.
Radish Seed (Laifuzi) 10g, Areca Peel (Dafupi) and Polygonum Orientale Fruit (Shuihonghuazi) 10g each, Perilla Seed (Suzi) 10g, White Mustard Seed (Baijiezi) 6g, Gleditsia Sinensis Pod (Zaojiao) 6g, Polygonum Orientale Fruit (Shuihonghuazi) 10g, Jiao Sanxian 10g each, Rhubarb Root (Dahuang) 6g, Achyranthes Root (Niuxi) 10g, 7 doses.
Second Visit
After medication, bowel movement is smooth, dizziness reduced, night sleep improved, feeling comfortable in the chest. Tongue coating is gradually resolving, pulse remains wiry and slippery. Phlegm and Stasis intermingled cannot be removed in one day. Must regulate diet, avoid rich foods, and exercise regularly; this is the fundamental strategy. Otherwise, relying solely on medication is useless. Adjust the previous method.
Radish Seed (Laifuzi) 10g, Perilla Seed (Suzi) 10g, White Mustard Seed (Baijiezi) 6g, Winter Melon Seed (Dongguazi) 10g, Gleditsia Sinensis Seed (Zaojiaozi) 6g, Polygonum Orientale Fruit (Shuihonghuazi) 10g, Areca Peel (Dafupi) and Polygonum Orientale Fruit (Shuihonghuazi) 10g each, Jiao Sanxian 10g each, Salvia Root (Danshen) 10g, Rubia Root (Qiancao) 10g, Imperata Rhizome (Maogen) and Reed Rhizome (Lugen) 10g each, Rhubarb Root (Dahuang) 6g, 10 doses.
Third Visit
Patient persisted with the above prescription for 1 month, followed medical advice to restrict diet (basically vegetarian), and strengthened exercise, walking 2-3 hours daily. Weight decreased by over 10 jin. Movement is more agile, head no longer dizzy, energy increased, feeling younger. Advised to stop medication, focus on exercise, and arrange diet reasonably, mainly vegetarian.
[Commentary]: Individuals who are obese with wiry, slippery, and forceful pulses mostly suffer from Phlegm-Stasis intermingling, manifesting as vertigo, numbness, pain, etc. The pathogenesis is Turbid Phlegm obstructing collaterals; treatment involves purging Phlegm and unblocking collaterals. Master Zhao commonly uses San Zi Yang Qin Tang added with Winter Melon Seed and Gleditsia Sinensis Seed, named Wu Zi Di Tan Tang (Five Seeds Phlegm-Purging Decoction), which effectively removes Phlegm and unblocks collaterals. Combined with Areca Peel, Polygonum Orientale Fruit, and Jiao Sanxian to regulate the Triple Burner. For dry stool, Rhubarb is essential to purge. For limb numbness/pain, add Luffa Reticulate Vine (Sigualuo) or Mulberry Twig (Sangzhi) to unblock collaterals. For blood stasis, add Salvia Root, Rubia Root, Red Peony Root, or Achyranthes Root. If there is Lower Yuan deficiency presenting as Upper Excess and Lower Deficiency, add Eucommia Bark, Cyathula Root, or Psoralea Fruit. Using seeds to purge Phlegm is an indispensable method, being Master Zhao's secret technique for treating Phlegm.
Headache 1 (Neurotic Headache)
Zhang XX, Female, 47 years old
First Visit
Headache occurs frequently, worsening before menstruation. Menstrual blood is dark and contains clots. Tongue is red and dry; mental restlessness and irritability. Pulse is wiry, slippery, and rapid. Stool is dry, urine is yellow and red. Blood Deficiency with Liver Yang Hyperactivity, Deficient Heat disturbing upwards, causing pre-menstrual headache. Dark menstrual blood with clots indicates Blood-level Stasis-Heat.
Use cooling Blood and removing Stasis, simultaneously reducing Heat, nourishing Yin and extinguishing Wind. Treatment focuses on the Eight Extraordinary Vessels.
Motherwort Herb (Yimucao) 10g, Red Peony Root (Chishao) 10g, Salvia Root (Danshen) 10g, Rubia Root (Qiancao) 10g, Stir-fried Gardenia Fruit (Chao Shanzhi) 6g, Bupleurum Root (Chaihu) 6g, Raw Rehmannia Root (Sheng Dihuang) 10g, Scrophularia Root (Yuanshen/Xuanshen) 10g, Ophiopogon Tuber (Maidong) 10g, Rhubarb Root (Dahuang) 1g, 7 doses.
Second Visit
Menstruation arrived, headache significantly reduced compared to before. Menstrual color is bright red, clots reduced. Pulse is rapid, tongue is red. Blood-level Stagnant Heat is not fully cleared. Continue with modifications of the previous method.
Motherwort Herb (Yimucao) 10g, Lygodium Spore (Zelan Ye) 10g, Red Peony Root (Chishao) 10g, Salvia Root (Danshen) 10g, Rubia Root (Qiancao) 10g, Bupleurum Root (Chaihu) 6g, Scutellaria Root (Huangqin) 10g, Toosendan Fruit (Chuanlianzi) 10g, Raw Rehmannia Root (Sheng Dihuang) 10g, Scrophularia Root (Xuanshen) 10g, 7 doses.
Third Visit
Patient feels comfortable after medication, no headache, night sleep improving, appetite normal. Tongue is red with white coating, pulse is soggy and quiet, slightly rapid upon pressure. Liver Heat has resolved. Switch to nourishing Blood and nurturing Yin method.
Raw Rehmannia Root (Sheng Dihuang) 10g, Red Peony Root (Chishao) and White Peony Root (Baishao) 10g each, Ligustrum Fruit (Nvzhenzi) 10g, Eclipta Herb (Hanliancao) 10g, Bupleurum Root (Chaihu) 6g, Scutellaria Root (Huangqin) 10g, Toosendan Fruit (Chuanlianzi) 10g, Salvia Root (Danshen) 10g, Rubia Root (Qiancao) 10g, Motherwort Herb (Yimucao) 10g, 10 doses.
Continuing with modifications of the above formula until the next menstruation, the headache did not recur. Menstrual color, volume, and quality were normal. The disease was cured.
[Commentary]: The patient's headache occurred before menstruation. Combined with dark menstrual blood and clots, it is known to be Blood-level Stasis-Heat. The Liver is the Sea of Blood and the congenital foundation for women. Blood Heat makes Liver Yang vigorous, leading to Liver Yang Hyperactivity, irritability, and dream-disturbed sleep. Many women suffer from this type of headache. Treatment should start with regulating menstruation, draining Blood-level Stasis-Heat, using cooling Blood and removing Stasis methods. Thus, the formula contains no specific anti-headache herbs, only clearing Liver Heat, cooling Blood Heat, and activating Blood Stasis.
As Blood Heat gradually clears and menstruation returns to normal, the headache naturally heals. TCM treatment does not merely treat symptoms but seeks the cause through pattern differentiation. In the third visit, Blood Heat and Liver Heat had resolved, so the focus shifted to nourishing Blood and nurturing Yin. When Yin is sufficient and Blood充盈, the Liver Body is nourished, menstruation becomes normal, and headache is prevented.
Headache 2 (Neurotic Headache)
Yu XX, Female, 50 years old. Headache for over 10 years, frequent attacks. Pain radiates to the eyes causing distension, relieved only by analgesics. In recent years, takes 1-2 packets of headache powder daily, otherwise unbearable. Widowed for over 20 years, emotional frustration led to internal郁 Fire (Stagnant Fire), Wood Fire disturbing upwards, causing headache. Although this is the common rationale, previous treatments with clearing Heat, nourishing Yin, cooling Blood, and extinguishing Wind were ineffective. Pulse is weak; tongue is white and moist, lacking Heat signs. The head is the meeting place of all Yang meridians; the Three Yang meridians all ascend to the head. The Classics state: "Clear Yang emerges from the upper orifices," resulting in sharp hearing and vision. Now, Clear Yang fails to ascend, and Turbid Yin counterattacks upwards. Over time, collateral vessels become obstructed. Hence, persistent headache. Propose method to raise Clear Yang, invigorate Blood, and unblock collaterals.
Ligusticum Rhizome (Chuanxiong) 30g, Leonurus Fruit (Chongweizi) 30g.
These two herbs constitute one dose, decocted as tea, drink as desired.
After taking the above prescription as tea, the headache ceased immediately.
[Commentary]: This headache has persisted for a long time without healing. Treat it as "disease entering collaterals due to duration." Ligusticum Rhizome invigorates Blood and moves...