Case Histories - Menstrual Headaches (2)
A 40-year-old woman had been suffering from headaches before and
after the period: interestingly, the headaches had started after
an operation for sterilization (tube ligation). The headaches were
located behind the eyes, on either side, and were throbbing in nature;
they were accompanied by nausea, blurred vision, a bitter taste,
thirst and dizziness. Her periods were regular and rather scanty.
On interrogation, it transpired that she also suffered from palpitations,
dizziness, tingling of her limbs, poor memory, blurred vision and
night-sweating. Her tongue was Pale and Swollen and her pulse was
Choppy and Weak, particularly on both Rear positions.
Diagnosis
The headaches are typical of Liver-Yang rising with their throbbing
character, dizziness, blurred vision and nausea. The bitter taste
and thirst also indicated some Liver-Fire. The origin of Liver-Yang
rising was primarily Liver-Blood deficiency as was clearly shown
by the blurred vision, dizziness, poor memory, tingling, scanty
periods, Pale tongue, Choppy pulse and palpitations (this last symptom
due to Liver-Blood deficiency affecting Heart-Blood). There was
a slight Kidney deficiency as evidenced by the night sweating and
Weak pulse on both rear positions. Finally, there was also some
Phlegm and Spleen-Qi deficiency as evidenced by the Swollen tongue.
Treatment
The treatment principle adopted was to nourish Liver-Blood, tonify
the Spleen, subdue Liver-Yang and tonify the Kidneys. I treated
her with herbal medicine and acupuncture.
Acupuncture
I used a simple treatment with few points such as:-
LU-7 Lieque (on the right) and KI-6
Zhaohai (on the left) to regulate the Directing Vessel, regulate
the periods and strengthen the Uterus.-
T.B.-5 Waiguan to subdue Liver-Yang
and treat the headaches.-
ST-36 Zusanli and SP-6
Sanyinjiao, with warm needle to tonify the Spleen and nourish Blood.
Herbal treatment
I used a decoction based on the Three Treasures (or East West Treasures)
remedy Bend Bamboo:
Dang Gui Radix
Angelicae sinensis 9g
Chuan Xiong Radix
Ligustici Chuanxiong 3g
Shu Di Huang Radix
Rehmanniae glutinosae praeparata 9g
Bai Shao Radix
Paeoniae lactiflorae 6g
Ju Hua Flos
Chrysanthemi morifolii 6g
Man Jing Zi Fructus
Viticis 4.5g
Gou Teng Ramulus
Uncariae 6g
Bai Ji Li Fructus
Tribuli terrestris 3g
Gou Qi Zi Fructus
Lycii chinensis 6g
Fu Ling Sclerotium
Poriae cocos 6g
Bai Zhu Rhizoma
Atractylodis macrocephalae 6g
Ban Xia Rhizoma
Pinelliae ternatae 6g
Zhi Gan Cao Radix
Glycyrrhizae uralensis praeparata 3g
Explanation
Dang Gui, Shu
Di Huang, Bai Shao and Chuan
Xiong form the Si Wu Tang Four Substances Decoction which
nourishes and invigorates Blood.-
Man Jing Zi, Bai
Ji Li, Ju Hua and Gou
Teng subdue Liver-Yang and treat headaches.-
Gou Qi Zi nourishes Blood and tonifies
the Kidneys.-
Fu Ling, Bai
Zhu and Ban Xia tonify Spleen-Qi
and resolve Phlegm.-
Zhi Gan Cao harmonizes.
After the first decoction, I added Xia Ku Cao Spica Prunellae vulgaris
4.5g remembering that there was also some Liver-Fire (bitter taste
and thirst).
After four courses of decoctions (of 15 days each) she was completely
free of headaches. |
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