Main Signs and Symptoms
Initially the episodes began with the onset of menstruation and stopped after the bleeding had ceased, and she thought that it was just part of her PMS. Over the past few months she has experienced severe dizziness with nausea for two to three days each week and the severity is increasing to the point that she is now unable to work. Sometimes the dizziness is so severe she feels like she is spinning around (i.e. vertigo).
Pulse: deep and slippery
Tongue: thin white and greasy coat
Diagnosis and Treatment
Phlegm blocking the clear orifices; stagnation of Phlegm due to Blood stasis.
Xue Fu Zhu Yu Tang (Persica & Cnidium Formula)
After one week she reported a dramatic improvement. She continued to improve and by the end of three weeks she was symptom free. She stopped treatment at this point and has not had any recurrence.
This is a case of Meniere’s disease that illustrates the pathogenesis of a complex condition due to long term stagnation of the Qi. Qi stagnation may arise due to the effects of prolonged stress, emotional strain, and lack of sufficient exercise. Generally the Liver become impaired and is no longer able to ensure the smooth and even flow of Qi throughout the body. Subsequently, the Spleen-Stomach systems become compromised because their major functions of transformation and transportation (of food and fluids) depend on the Liver’s spreading (or ‘free coursing’) actions. The resulting stagnation in the Spleen-Stomach lead to the development of Damp and Phlegm, both of which tend to cause further stagnation and exacerbate the problem. Phlegm may then be carried to the upper Jiao by the Spleen’s ascending movement, where it blocks the clear orifices (or ‘orifices of the Heart), in this case leading to dizziness and vertigo. Phlegm-Damp stagnation in the middle Jiao (affecting the Stomach and Spleen) may also lead to recurring nausea. Blood stasis, on the other hand, may arise directly from Qi stagnation, as the normal movement of the Blood depends on normal free movement of the Qi. Once Phlegm has developed, Blood stasis may more readily arise due to the additional burden on the free movement of the Qi due to the stagnating action of the ‘heavy’ pathogens (i.e. Damp and Phlegm). It should be noted that in this case the Phlegm was treated indirectly by focusing the treatment on moving the Qi and activating the Blood. Once the Qi and Blood are moving normally, the Phlegm and Damp are no longer generated and are naturally resolved. If the patient had not responded or was only responding very slowly to treatment, the formula Wen Dan Tang (Bamboo & Hoelen Formula) could have been added to the protocol.