Dizziness Xuan Yun due to Phlegm Damp
Terms
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Dizziness due to Phlegm Damp
Pathophysiology -
-Dizziness caused by Phlegm Damp presents in two ways; 1) Pure Excess 2) mixture of Phlegm Damp and Spleen Qi Deficiency.
1) due to overconsumption in general particularly dairy or fatty foods gnereates Phlegm Damp with no underlying deficiency. If Phlegm persisits the Spleen is eventually weakened and will contribute to the ongoing production of Phlegm Damp.
Causes dizziness by obstructing the passage of qi and 'clear ayng' to the head. OR by accumulating in the head and settling over the orifices like a mist. In the latter case Phlegm is often carried to the head with the rising Yang or Wind (Wind Phlegm) and indeed Phlegm frequently occurs with Liver Yang. The pent up Yang may be pre-existing, or the presence of Phlegm can cause stagnation and obstruct the qi, which at some point of critical intensity escapes as rising Yang. In the head, Phlegm obstructs the ascent of 'clear yang' and the descent of 'turbid Yang' leading to an imbalance in distribution of yin and yang, and relatively severe dizziness/vertigo. -
Dizziness due to Phlegm Damp
Clinical Features -
-Dizziness or vertigo, sometimes enough to make a patient fall over
-May be triggered by movement of the head or strong smells, or have no obvious trigger, the sensation is sometimes likened to being on a ship, or having a world spin around-even in bed 'bedspins'
-tinnitus, usually during episodes of dizziness
-nausea or vomiting
-poor appetite
poor concentration, wooly head or sensation its 'wrapped in a wet cloth'
-frontal headaches
fullnes and discomfirt in the chest and epigastrium
-heaviness in the body, lethergy
-frequent desire to sleep
T-pale and swollen, with a greasy white ocat
P-slippery or soft and soggy -
Dizziness due to Phlegm Damp
Treatment Principle and Prescription -
TP: Dry Dampness, Transform Phlegm, Strengthen the Spleen and harmonise the Stomach
RX: BAN XIA BAI ZHU TIAN MA TANG
Ban Xia 9
Bai Zhu 12
Tian Ma 6
Chen Pi 6
Fu Ling 9
Gan Cao 3
Sheng Jiang 3 pc
Da Zao 3pc -
Dizziness due to Phlegm Damp
Modifications for:
-Severe dizziness and nausea
-Frontal Headache
-Qi Deficiency
-Epigastric Fullness and loss of appetite
-Tinnitus is severe and persistent -
Severe dizziness and nausea:
increase Tian Ma to 9
and add 1 or 2 of the following:
Dai Zhe Shi 15
Xuan Fu Hua 9
Jiang Can 9
Dan Nan Xing 6
Frontal Headache:
+ Bai Zhi 9
Qi Deficiency (short of breath, low voice, sweating during the day):
+ Dang Shen 15
Huang Qi 15
Epigastric Fullness and loss of appetite:
Bai Dou Kou 6
Sha Ren 6
Tinnitus:
+Shi Chang Pu 6 -
Dizziness due to Phlegm Damp
Modifications for:
Thick wet greasy tongue coating (indicating severe Dampness and fluid metabolism dysfunction) -
+ WU LING SAN
Zhu Ling 6
Ze Xie 6
Bai Zhu 6
Gui Zhi 6
Fu Ling 6 -
Dizziness due to Phlegm Damp
And
Phlegm Heat -
A frequent complication of Phlegm Damp as the resulting obstruction easily generates Heat.
-flushing during episodes of dizziness,
-anxiety
-palpitations
-nausea
P- slippery, rapid
T- greasy yellow coat
TP: Resolve Hot Phlegm
RX: WEN DAN TANG modified
Zhu Ru 6
Zhi Shi 6
Ban Xia 6
Chen Pi 6
Fu Ling 6
Gan Cao 3
Sheng Jiang 3 pc
Huang Qin 9
Shi Chang Pu 9
Huang Lian 6
Tian Zhu Huang 6 -
Dizziness due to Phlegm Damp
and
Spleen Deficiency with Phlegm Damp -
If Spleen Def. is the source of Phlegm
TP: Strengthen the Spleen to resolve Phlegm
RX: LIU JUN ZI TANG modified
Chao Bai Zhu 12
Zhi Huang Qi 12
Fu Ling 12
Ren Shen 9
Ban Xia 9
Chen Pi 6
Zhu Ru 6
Dan Nan Xing 6
Bai Jie Zi 6
Zhi Gan Cao 6 -
Dizziness due to Phlegm Damp
and
Spleen Yang Deficiency with Phlegm Fluids -
Spleen Yang Deficiency can give rise to thin fluids causing
-dizziness
-fullness in chest and epigastrium
-palpitations
-shortness of breath
-cough with thin sputum
T-Pale, swollen
P-Slippery
TP: Warm and transform Phlegm and fluids and strengthen the Spleen
RX: LING GUI ZHU GAN TANG modified
Fu Ling 12
Bai Zhu 9
Gui Zhi 6
Zhi Gan Cao 3
Gan Jiang 6
Zhi Fu Zi 3 (30mins before)
Bai Jie Zi 6 -
Dizziness due to Phlegm Damp
Patent Medicines -
ER CHEN WAN
ban xia, chen pi, fu ling, sheng jiang, gan cao
XIANG SHA LIU JUN ZI WAN
(Sp Def with Phlegm)
bai zhu, fu ling, da zao, dang shen, ban xia, chen pi, sha ren, mu xiang, gan cao, sheng jiang
FU ZI LI ZHONG WAN
fu zi, dang shen, gan jiang, bai zhu, gan cao -
Dizziness due to Phlegm Damp
Acupuncture -
Tou Wei ST-8
Zhong Wan RN-12
Shang Qiu SP-5
Nei Guan PC-6
Jian Shi PC-5
Qiu Xu GB-40
Feng Long ST-40 (-)
Jie Xi ST-41 (-)
Yin Ling Quan SP-9
with SP Def:
Pi Shu BL-20 (+)
Zu San Li ST-36 (+) -
Dizziness due to Phlegm Damp
Clinical Notes -
This pattern may be associated with Meniere's disease, benign positional vertigo, hypertension or chronic congestion of the middle ear
This pattern can respond well to correct treatment and dietary modification.