Case 1

Name: Zhu.

Sex: Male.

Age: 42 years.

0ccupation: A driver.

Chief Complaint: Dizziness and headache for more than 3 years.

History of Present Illness: More than 3 years ago, the patient got dizziness and headache slowly, it's a constant dull pain located in the right parietotemporal region and could be easily turned into a sharp prickling like pain by catching a cold; the dizziness occurred paroxysmally, usually it was induced by severe headache. In the past 3 years, the above syndrome got sometimes mild and sometimes severe. After many times' treatment of Western medicine, TCM, acupuncture and massage, the sickness could not be cured completely yet. During the treatments, his dizziness and headache got mild, while the treatments finished, the syndrome became as same as before. Sometimes the bad headache prevented him from working on. On December 8,1999, when he was driving, the severe headache made he couldn't drive on. Then he came to our hospital for treatment.

Physical Examination: The patient was conscious with a normal general condition. The pulse was taut, thready and uneven, the tongue was red with a thin layer of white fur. The shape of head was normal. There wasn't tenderness in the affected region. There was not other abnormal sign.

Diagnosis: Angioneurotic Headache.

Differentiation: It's stagnation of qi in liver channel, which caused qi stagnation and blood stasis in the meridian of the head. In addition, exogenous pathogenic wind and cold attacked the body from the exterior and got into the superficies, which resulted in obstruction of meridian qi at the top of head. So that the patient got the severe headache.

Therapeutic Principle: Relieving of secondary symptoms in emergency while treatment of chronic disease aiming at the principal aspect. Because there was a sharp prickling-pain currently, it's necessary to use acupuncture to dredge the obstructed meridian passage and relieve the pain quickly. In addition, because this sickness was a chronic illness of many years, curative effect of using Chinese herbs and acupuncture would not persist for a long term, then it's necessary to use medicinal liquor to keep a long time of curative effect. Only by this way, could the inveterate illness be cured completely.

Acupuncture Method: I pricked the point of Yemen(TE2) with a 1.5 cun needle, manipulating the needle with reducing skill.

After 1 time's acupuncture, the sharp prickling pain dis-appeared at once, only dizziness and distending sensation of head were there. Then he was told to make the medicinal liquor. The prescription of medicinal liquor was as follow. Recipe:

JinQianBaiHuaShe,Multibanded Krait 8 ones

QiShe,I.ong-noded Pit Viper 15g

WuShaoShe,Black-tail Snake 15g

ChuanShanJia,Pangolin Scale 15g

DiBieChong,Ground Beetle 20g

QuanXie, Scorpion 15g

WuGong, Centipede 15g

QiangHuo,Notopterygillm Root 25g

JiXueTeng,Spatholobus Stem 60g

GaoBen,Ligusticum Root 25g

GouQiZi,Wolfberry Fruit 30g

XiXin,Asarum Herb 25g

HuangQi,Milkvetch Root 60g

DangGui,Chinese Angelica Root 25g

FangFeng,Ledebouriella Root 20g

ChuanXiong,Chuanxiong Rhizome 30g

ShuDiHuang,Prepared Rehmannia Root 90g

TianMa,Gastrodia Tuber 30g

GouTeng, Hooked Unearia 30g

YuanZhi,Polygala Root 20g

ShiChangPu,Grassleaved Sweetflag Rhizome 20g

All the above drugs were to be soaked into 3kg of spirit distilled from sorghum. The wine jug was sealed hermetically. 2 months later, it's the time to begin drinking the medicinal liquor, only 1 little cup of the liquor each time,2 times a day.

Effect Observation: After half a month of taking the medicinal liquor, there were not the dizziness, headache and the distending sensation of head. Then the patient was told to continue taking the medicinal liquor. After 1 year' s follow-up, the sickness didn' t recur. Then it' s ending.

Case 2

Name: Wang.

Sex: Male.

Age: 46 years.

0ccupation: A woodworker.

Chief Complaint: Headache for 25 years.

History of Present Illness: Twenty-five years ago, the patient got a headache without any obvious causes. It occurred intermittently and was often induced by overwork or mental tension. When the attack came on, the patient got a distending pain and a sensation of bursting in the both sides of 0ccipitotemporal region, it seemed that his scalp was constricted. It severely prevented him from normally working and living. After the illness came on, he asked innumerable doctors for treatment and was separately treated with "Piminodine, Brufen, Carbamazepine Pills of Gastrodiae" and so on, the pain was

relieved. But in recent 2 years, the recurrence of the illness got more and more in frequency, and the affected region was extended from both occipitotemporal part to forehead. Once the attack recurred, the headache was so sharp that he couldn't

stand it. Then he came to our hospital for treatment on March 20,1998. In addition, the patient usually got dry mouth and annoy. His stool was dry and cositive, it was moved once every 2 or 3 days, his urine was yellow and scanty, his appetite and sleeping were all normal.

Physical Examination: The patient was conscious with a normal general condition. The pulse was taut and floating. The tongue was dark red with a thick layer of dry yellow fur. The shape of the head was normal. There wasn't other abnormal sign.

Diagnosis: Angioneurotic Headache.

Differentiation: It belongs to the category of "PianTouTong" (migraine) in TCM. Because the affected parts were located in 0ccipitotemporal part and forehead, it belonged to "YangMing Headache" and "ShaoYang Headache. "In addition, the pulse and the tongue reflected there was stagnant heat in the interior organ.

Therapeutic Principle: Expelling evils both in the superficies and the interior, expelling superficial evils and clearing away heat together.

Recipe: Miraculous Bolus of Ledebouriellae.

FangFeng,Ledebouriella Root 15g

JingJie, Schizonepeta 15g

I.ianQiao,Forsythia Fruit 15g

MaHuang, Ephedra 15g

BoHe,Peppermint Herb 15g

ChuanXiong,Chuanxiong Rhizome 15g

DangGui,Chinese Angelica Root 15g

BaiShao,White Peony Root 15g

BaiZhu,Bighead Atractylodes Rhizome 15g

ZhiZi,Parched Capejasmine Fruit 15g

JiuDaHuang,Rhubarb 15g (fried with spirit)

MangXiao, Mirabilite 15g

ShengShiGao, Gypsum 30g

HuangQin,Scutellaria Root 30g

JieGeng,Platycodon Root 30g

HuaShi, Talc 50g

GanCao,Liquorice Root 30g

The above drugs were ground together into powder and mixed with water to make pills. 8g of the pills were taken each time,3 times a day. Greasy and hot food was forbidden during the treatment.

Effect Observation: After 10 days' treatment, the headache was relieved greatly, there wasn't pain in forehead and both sides of occipitotemporal regions. After half a year's follow up, the illness didn't recur. Then it's ending.

Case 3

Name: Wang.

Sex: Female.

Age: 68 years.

0ccupation: A peasant.

Chief Complaint: Headache and dizziness for 12 years.

History of Present Illness: Twelve years ago, the patient got headache and dizziness without any obvious causes. It's a constant dull pain, accompanied with a heavy sensation of the head; once it was raining or overcast, or she was overworking, the above symptom was aggravated. Sometimes the aggravated headache could become a sharp prickling like pain, accompanied with a sensation of numbness on her face, the affected region wasn't limited. Furthermore, there was an involved aching-pain in the neck and back, which prevented her from holding up the right arm as normal. If she tried holding up her right arm, she would get an insufficient pain immediately. After many times of treatment in the local hospital, there was little curative effect on her. Then she came to our hospital for treatment on January 18, 1996.

Physical Examination: The patient was spiritless with a weak general condition. She got lassitude and fatigue. The pulse was floating and taut, the tongue was red with a thick layer of watery fur. The shape of the head was normal. There was a sharp tenderness on the left region and the top of the head, where couldn't be pressed because of the sharp tenderness. There wasn't other abnormal sign.

Diagnosis: Angioneurotic Headache.

Differentiation: This disease, in TCM, belongs to the category of "TouFeng, PianTouTong ( head wind syndrome, migraine) ". It was caused by upward retention of phlegm-dampness in head and deficiency of liver and kidney. As a result of deficiency of liver and kidney, there was hyperactivity of asthenic liver-Yang, which was reflected by the taut pulse and the red tongue; as a result of upward retention of phlegm-dampness in head, there were dizziness, lassitude and fatigue. In addition, there was attack of exogenous pathogenic wind and cold from the exterior, which was reflected by the involved aching-pain in the neck and the back and the floating pulse.

Therapeutic Principle: Eliminating phlegm-dampness and calming hyperactivity of liver-Yang, nourishing liver and kidney, activating blood and resoling blood-stasis.

Recipe:

ShuDiHuang,Prepared Rehmannia Root 30g

BaiShao,White Peony Root 30g

HuangQi,Milkvetch Root 30g

DangGui,Chinese Angelica Root 15g

GouQi,Wolfberry Fruit 25g

YuanZhi,Polygala Root 20g

ShiChangPu,Grassleaved Sweetflag Rhizome 20g

ZhiFuZi,Prepared Aconite Root 12g

QiangHuo,Notopterygillm Root 20g

GaoBen, Ligusticum Root 15g

DiLong, Earthworm 15g

BaiJiangCan,Batryticated Silkworm 15g

ChuanXiong,Chuanxiong Rhizome 20g

HongHua, Safflower 10g

GanCao,Liquorice Root 10g

All the above drugs were to be decocted in water for oral taking. 5 doses were prescribed.

Effect Observation: After taking the decoction, the patient came back and said the involved aching-pain in the neck and back had disappeared, she could hold up the right arm freely while the headache was as same as before, and there were abdominal distending and anorexia. Physical examination showed the pulse was thready and taut, the tongue was red with a greasy layer of white fur. Then the differentiation should be hyperactivity of liver-Yang and retention of dampness, which caused a failure of spleen to transportation and transformation. The corresponding therapeutic principle should be strengthening the curative effect of eliminating pathogenic damp phlegm and soothing the hyperactive liver-Yang. Recipe :

DangShen,Pilose Asiabell Root 30g

ShuDiHuang,Prepared Rehmannia Root 25g

ShaYuanZi,Flatstem Astragalus Seed 25g

GouQiZi,Wolfberry Fruit 25g

QuanXie, Scorpion 10g

WuGong, Centipede 10g

GouTeng, Hooked Uncaria 15g

TianMa,Gastrodia Tuber 20g

YiYiRen,Coix Seed 30g

CangZhu,Atractylodes Rhizome 20g

ZhiNanXing,Arisaema with Bile 12g

HongHua, Safflower 10g

ChuanXiong,Chuanxiong Rhizome 15g

GanCao,Liquorice Root 10g

All the above drugs were to be decocted in water for oral taking. 5 doses were prescribed.

Effect Observation: After taking the decoction, the dizziness and headache disappeared, the abdominal distending and anorexia disappeared too. There was not other uncomfortable sensation. After half a year's follow-up, the sickness didn't recur. Then it's ending.

Case 4

Name: Ma.

Sex: Female.

Age: 30 years.

0ccupation: A worker.

Chief Complaint: Headache and dizziness for half a month.

History of Present Illness: Half a month ago, the patient got a headache without any obvious causes, it was a continuous distending-pain and located in both parietotemporal regions. It seemed that the scalp of the affected regions was constricted by a hoop, it caused she got an insufferable distending-pain in the head. Usually the headache was accompanied with dizziness, bitterness of mouth, dryness of throat and distending-pain of breasts. Furthermore, there were distending pain of eyes, burning sensation of eye-sockets and hectic fever of both cheeks. Then she went to the department of internal medicine of a hospital for treatment, she was treated with oral medicating "Brufen, Capsul of Gastrodiae. " After half a month's treatment, her suffering from the illness couldn' t be relieved yet. Then she came to our hospital for treatment on December 25,1999.

Physical Examination: The patient was conscious with a hectic complexion. The pulse was taut and rapid, the tongue was dark red with a thin layer of white fur. The shape and structure of the head were all normal. There was no abnormal sign in the both parietotemporal regions. No tenderness could be found in the affected regions. The movement of the neck was not limited. There wasn't other abnormal sign.

Diagnosis: Angioneurotic Headache.

Differentiation: It's hyperactivity of liver-Yang, which caused the up-flaming of deficiency-fire and fled along Foot Jueyin Liver Channel. As a result of it, a special phenomenon arose: where the Jueyin Liver Channel extends, there was suffering from the illness. The liver channel extends upward through the breast, then there was distending-pain in the breast; the liver channel surrounds the eyes and is associated with the eyes as its orifices, then there were a sensation of burning in the eye-sockets and a distending-pain in the eyes; the liver-channel extends upward through the parietotemporal regions and ends at the top of the head, then there was a distending pain in the parietotemporal regions and the top of the head. This phenomenon is the typical syndrome of the evil's fleeing along the channel.

Therapeutic Principle: Clearing away heat to cool blood; expelling the heat evil in the organs by taking purgative herbs; soothing liver to relieve depression; activating blood to resolve stasis; relieving the superficies-syndrome with pungent-flavored and cool-propertied herbs; sending the asthenic fire downward.

Recipe:

ShengDiHuang,Dried Rehmannia Root 15g

MuDanPi,Tree Peony Bark 12g

HuangI.ian,Coptis Root 6g

HuangQin,Seutellaria Root 6g

YuanHu,Corydalis Tuber 9g

ChaiHu,Bupleurum Root 8g

TaoRen,Peach Seed 12g

HongHua, Safflower 12g

ChiShao,Red Peony Root 12g

NiuXi,Achyranthes Root 18g

ZhiKe,Fruit of Citron 12g

ShanZhi,Capejasmine Fruit 9g

ChuanXiong, Chuanxiong Rhizome 12g

BoHe,Peppermint Herb 12g (to be decocted later)

ShengDaHuang,Raw Rhubarb 9g (to be decocted later)

All the above drugs were to be decocted in water for oral taking. 5 doses were prescribed, taking the decoction in morning, afternoon and evening separately.

Effect Observation: After taking the 1st dose, the headache disappeared at once, the dizziness was relieved greatly; after taking the 3rd dose, all the uncomfortable sensation disappeared; after taking the 5th dose, the patient was in health. Then she was to1d to take 2 doses of the original prescription again to make pills, take 6g of the pills each time,3 times a day. She should take the pills in order to keep a long time of curative effect. After halt a year's follow up, the illness didn't recur. Then it's ending.