15. Dizziness (Xuan yun)
Definition
Subjective sensation of blurred vision, sensation of turning in space or objects self-movement.
In TCM,
Xuan: sensation of blurred, dark or dull vision.
Yun: sudden spinning sensation or perception that the surroundings are spinning.
Relevant modern diagnosis:
1. Physiologic dizziness:
(1) the brain is confronted with a mismatch among the three stabilizing sensory systems;
(2) the vestibular system is subjected to unfamiliar head movements to which it has never adapted, such as in seasickness; (3) unusual head/neck positions, such as the extreme extension when painting a ceiling.
2. Pathologic dizziness
1. Vestibular dysfunction--- vertigo accompanied by nausea, jerk nystagmus, postural unsteadiness, and gait ataxia.
(1) Meniere’s disease
(2) purulent or serous labyrinthitis
(3) toxic labyrinthitis due to drug intoxication (e.g., with alcohol, quinine, streptomycin, gentamicin, and other antibiotics)
2. Abnormal blood pressure
(1) hypotension,
(2) hypertension
3. Metabolism disorder
(1) hypoglycemia
4. Trauma
(1) eighth cranial nerve injury
(2) head injury
5. Others
(1) anemia
Etiology & pathogenesis
1. Liver yan rising
2. qi and blood deficiency
3. kidney essence deficiency
4. phlegm-dampness accumulation
Differential diagnosis
1. headache
2. wind stroke
Treatment
1. Liver yan rises---dizziness, headache, insomnia, red tongue, yellow coating, wiry pulse.
Pacify liver, subdue yan, and nourish liver & kidney
Tian ma gou teng yin
Tian ma, Gou teng, Shi jue ming---
Zhi zi, Huang qin---
Yi mu cao, Niu xi---
Duzhong, Sang ji sheng---
Ye jiao teng, Fu shen---
GB 20, BL 18, BL 23, KI 3, LR 2
2. Phlegm-dampness obstruction---dizziness, headache, stuffy chest, poor appitite, white greasy tongue coating, slippery pulse.
Dry dampness, resolve phlegm, augment spleen and harmonize stomach
Ban xia bai zhu tian ma tang
Tian ma ---
Ban xia, Chen pi---
Bai zhu, Fu ling---
ST 8, BL 20, CV 12, PC 6, ST40
3. Qi and blood deficiency---dizziness, palpitation, insomnia, poor appetite and fatigue
Tonify qi and nourish the blood
Gui pi tang
Ren shen, Huang qi, bai zhu---
Long yan rou, Fu shen, Shuan zhao ren---
Mu xiang---
CV 20, BL 20, CV 4, ST 36, SP 6
4. Kidney yang deficiency--- dizziness, cold intolerancecoldness and soreness of lower back and knees, deep and slow pulse.
Tonify kidney
You gui wan
Shu di huang, Shan yao, Shan zhu yu---
Gou qi zi, Du zhong, Tu si zi---
Dan gui---
Lu jiao jiao---
Fu zi, Rou gui---
Gv 20, BL 17, BL 23, CV 4, KI 6
5. Kidney yin deficiency--- dizziness, soreness of lower back and knees, red tongue with scanty coating, thready pulse.
Nourish kidney
Zuo gui wan
Shu di huang, Shan yao, Shan zhu yu---
Tu si zi, Gou qi zi---
Gui ban jiao, Lu jiao jiao---
Niu xi---
Gv 20, BL 17, BL 23, CV 4, KI 6
Personal clinical experience
Subjective sensation of blurred vision, sensation of turning in space or objects self-movement.
In TCM,
Xuan: sensation of blurred, dark or dull vision.
Yun: sudden spinning sensation or perception that the surroundings are spinning.
Relevant modern diagnosis:
1. Physiologic dizziness:
(1) the brain is confronted with a mismatch among the three stabilizing sensory systems;
(2) the vestibular system is subjected to unfamiliar head movements to which it has never adapted, such as in seasickness; (3) unusual head/neck positions, such as the extreme extension when painting a ceiling.
2. Pathologic dizziness
1. Vestibular dysfunction--- vertigo accompanied by nausea, jerk nystagmus, postural unsteadiness, and gait ataxia.
(1) Meniere’s disease
(2) purulent or serous labyrinthitis
(3) toxic labyrinthitis due to drug intoxication (e.g., with alcohol, quinine, streptomycin, gentamicin, and other antibiotics)
2. Abnormal blood pressure
(1) hypotension,
(2) hypertension
3. Metabolism disorder
(1) hypoglycemia
4. Trauma
(1) eighth cranial nerve injury
(2) head injury
5. Others
(1) anemia
Etiology & pathogenesis
1. Liver yan rising
2. qi and blood deficiency
3. kidney essence deficiency
4. phlegm-dampness accumulation
Differential diagnosis
1. headache
2. wind stroke
Treatment
1. Liver yan rises---dizziness, headache, insomnia, red tongue, yellow coating, wiry pulse.
Pacify liver, subdue yan, and nourish liver & kidney
Tian ma gou teng yin
Tian ma, Gou teng, Shi jue ming---
Zhi zi, Huang qin---
Yi mu cao, Niu xi---
Duzhong, Sang ji sheng---
Ye jiao teng, Fu shen---
GB 20, BL 18, BL 23, KI 3, LR 2
2. Phlegm-dampness obstruction---dizziness, headache, stuffy chest, poor appitite, white greasy tongue coating, slippery pulse.
Dry dampness, resolve phlegm, augment spleen and harmonize stomach
Ban xia bai zhu tian ma tang
Tian ma ---
Ban xia, Chen pi---
Bai zhu, Fu ling---
ST 8, BL 20, CV 12, PC 6, ST40
3. Qi and blood deficiency---dizziness, palpitation, insomnia, poor appetite and fatigue
Tonify qi and nourish the blood
Gui pi tang
Ren shen, Huang qi, bai zhu---
Long yan rou, Fu shen, Shuan zhao ren---
Mu xiang---
CV 20, BL 20, CV 4, ST 36, SP 6
4. Kidney yang deficiency--- dizziness, cold intolerancecoldness and soreness of lower back and knees, deep and slow pulse.
Tonify kidney
You gui wan
Shu di huang, Shan yao, Shan zhu yu---
Gou qi zi, Du zhong, Tu si zi---
Dan gui---
Lu jiao jiao---
Fu zi, Rou gui---
Gv 20, BL 17, BL 23, CV 4, KI 6
5. Kidney yin deficiency--- dizziness, soreness of lower back and knees, red tongue with scanty coating, thready pulse.
Nourish kidney
Zuo gui wan
Shu di huang, Shan yao, Shan zhu yu---
Tu si zi, Gou qi zi---
Gui ban jiao, Lu jiao jiao---
Niu xi---
Gv 20, BL 17, BL 23, CV 4, KI 6
Personal clinical experience
