7 Inquiry of the head and face
Many of the symptoms appearing on the head and face are also the manifestations of diseases of the whole body. The following is a brief discussion.
1.3.3.7.1 Vertigo
Vertigo means that the patient subjectively feels that his or her body or the things in sight are swirling. Vertigo may be caused by up-flaming of liver fire, hyperactivity of liver yang, encumbrance and stagnation of phlegmatic dampness, insufficiency of qi and blood as well as deficiency of kidney essence. Vertigo, accompanied by distension, flushed cheeks and red eyes, dysphoria, susceptibility to anger, hypochondriac pain and bitter taste in the mouth, is due to up-flaming of liver fire; vertigo, accompanied by distending pain, tinnitus and aching flaccidity of loins and knees, is usually caused by hyperactivity of liver yang; vertigo, accompanied by head heaviness like being bound, chest oppression, nausea and heaviness of limbs, is often caused by internal retention of phlegmatic dampness and failure of lucid yang to rise; vertigo, accompanied by lassitude, shortness of breath, lethargy to speak, pale complexion, light colour of tongue and aggravation after overstrain, is due to qi asthenia and blood deficiency which fail to nourish the upper part; vertigo, accompanied by vacuity sensation, tinnitus, amnesia and aching flaccidity of the loins and knees, is frequently caused by asthenia
of kidney essence.
1.3.3.7.2 Tinnitus
Tinnitus refers to noise in the ears like chirping of a cicada or tidal sound. Fulminant tinnitus like the noise made by frog or tide, which cannot be reduced
by pressure, is of sthenia syndrome due to exuberant liver and gallbladder fire to disturb the upper orifices; low and gradual tinnitus like chirping of a cicada,
which can be reduced or stop by pressure, is of asthenia syndrome due to asthenia of liver and kidney yin and hyperactivity of liver yang, or deficiency of kidney essence and insufficiency of brain which fails to nourish the ears.
1.3.3.7.3 Deafness and fliplacusis
Deafness means hypoacusis or even anakusis.The condition of hypoacusis, unclear hearing and hearing of repeated voice is called diplacusis. Sudden deafness and diplacusis are of sthenia syndrome due to accumulation of adverse rise of fire from the liver and gallbladder in the ears, or due to phlegmatic turbidity and pathogenic wind obstructing the ears; deafness and diplacusis in prolonged disease are usually of asthenia syndrome due to failure of essence to replenish the upper orifices resulting from asthenia.
1.3.3.7.4 Dizziness
Dizziness means swirling of things like sailing on a boat or flying of flies before the eyes. Dizziness and vertigo usually appear simultaneously. Dizziness caused by pathogenic wind and fire attacking the upper orifices or phlegmatic dampness confusing the upper orifices is of sthenia syndrome; dizziness due to prolapse of gastrosplenic qi and failure of lucid yang to rise, or due to insufficiency of the kidney and liver, deficiency of essence and blood as well as malnutrition of eyes, is of asthenia syndrome.
1.3.3.7.5 Ocular itching
Ocular itching means itching sensation in the eyelid, canthus or pupil of the eyes. Ocular itching can be eased by light rubbing in mild case. However, it is unto. arable in severe case which is usually of sthenia syndrome. Ocular itching like insects creeping with photophobia, tearing and scorching pain is caused by wind fire in the liver meridian disturbing the upper part. Mild itching and dryness of eyes is often due to malnutrition of the eyes caused by insufficiency of liver blood or asthenia of liver and kidney yin.
1.3.3.7.6 Ocular pain
Ocular pain refers to pain of one or double eyes which is usually of sthenia syndrome. Unbearable ocular pain, accompanied by red eyes, bitter taste in the mouth, irritability and susceptibility to anger is usually caused by up-flaming of liver fire. Red and swelling pain of eyes with photophobia and ocular excreta is a sign of wind heat disturbing the upper, usually seen in fulminant conjunctivitis or epidemic conjunctivitis.
1.3.3.7.7 Blurred vision, night blindness and diplopia
These three morbid conditions of eyes are of the signs of hypoacusis. Though characteristically different, they share the same cause and pathogenesis, usually caused by asthenia of the liver and kidney, insufficiency of essence and blood and malnutrition of eyes, often seen in the patients with chronic disease or the aged and weak people.
1.3.3.7.8 Pain and numbness of the tongue
Pain of the tongue is usually due to exuberance of fire in the liver, heart and stomach that affects the tongue. Numbness of the tongue is caused either by blood asthenia, yin asthenia and malnutrition of the tongue, or by stagnation of phlegm in the tongue collaterals. Besides, headache is also a commonly encountered symptom involving the head and face which is discussed in the part of inquiry of pain.
