According to the viewpoint of Traditional Chinese Medicine, vertigo is caused by weakness of spleen and enclosure of wetness, inability of discharging the hepatic evil which turns into heat to reach the brain under promotion of wind, and motivation of the evil of liver fire or phlegm fire that uprises to disturb the Qi of clarity in the body. Vertigo may also be induced by fatigue from overwork, inconstancy of meal time, embarrassment of passion and desire, deficiency of blood and energy, prolonged course of illness, over-lording water intake in a short time, intake of soup of excessive cold nature or taking certain drugs. Therefore, conditions that might cause motivation of hepatic fire, and injury of Qi and Yin are liable to induce vertigo.
“Vertigo” symptoms of the more severe type often include light-headedness, feeling like sitting in a boat or spinning of the head, tinnities or the feeling as if the heaven and earth were spinning round, and also nausea and vomiting. Asthenic patients may have the disease coming and going in a regular manner and the illness is generally diagnosed by modern doctors as imbalance of auricular fluid or Meniere’s syndrome.
Patients suffering from hepatophilic virus infection may pass to chronic hepatitis; they may show evidently an abundance of heart fire, liver fire and lung fire in the body. The large intestines may show dry-heat; the yin fluid showing deficiency and the kidney water lacking in amount. Therefore, in the early stage, there may be liver stagnation and dry-heat and also phlegm wetness and deficiency of energy. If the disease is not properly treated for a long time, it would undoubtedly lead to weakness of kidney and deficiency of blood and also weakness of liver and kidney. The occurrence of various degrees of “vertigo” symptoms is, therefore, extremely common. Chronic hepatitis patients may, at the same time, have symptoms of “auditory vertigo disease”. This can be explained entirely with the TCM principle of treatment according to syndrome differentiation. In fact, systemic TCM treatment causes attainment of clinical cure in chronic hepatitis and in most cases of auriculogenic vertigo, patients get significant relief or even curative results.
Classification according to syndrome differentiation of vertigo in TCM can be done in the same manner as chronic hepatitis; there are several forms of vertigo:
| ¨ wetness-heat vaporization form (vertigo with heaviness of the head, generalized soreness of the body, sensation of heaviness in the chest and obstruction in the air passage, feeling of surfeit and nausea, fatigue and insomnia, tongue coating smooth and pulse slippery);
¨ deficiency of blood and energy form
¨ stagnation of heat in liver and lung form
¨ deficiency of yin in liver and kidney form
The classification seems to be complicated, but it demonstrates the similarity of the pathogenic mechanism of hepatogenic vertigo and liver disease. In clinical practice, the use of effective systemic TCM therapy often gains definite curative results.
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Introduction of cases
| Case 1
Huang (Code No. 531) male, age 36 years. He was attacked by paroxysmal vertigo for one year. The attack were associated with sensation of spinning around of the heaven and earth and also nausea. He had a history of recurrent diarrhea. Brain scanning was performed with normal result. Renal calculus was found in 1990 and the urinary stone was discharged by himself in 1995. His first visit was on April 1997. Physical examination face pale looking, tongue enlarged with teeth prints (+) pitting edema of lower extremities, abdomen soft but distended with frog-like appearance, liver 1.5cm above costal margin with slight percussion tenderness. The impression was chronic hepatitis complicated with imbalance of auricular fluid (Menier’s syndrome.). After taking 3 parcels of TCM drugs, there was no more vertigo. Abdominal distention reduced significantly and percussion found a hepatomegaly of 3 cm; the lower extremities had still (+) pitting edema. After giving 18 parcels of TCM drugs to the patient, his liver returned to normal and edema of lower extremities disappeared. The course of treatment required 6 weeks and his vertigo did not relapse up to the present.
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| Case 2
Chan (code No. 237) male, age 48 years. His first visit was on Jan. 1997. He had a past history of appendectomy in 1976 and previous blood examination found type A hepatitis virus antibodies and he had received hepatitis B preventive injection. Four months ago, blood examination revealed high ferment level for which modern medicine did not have any effective therapy. In the recent three months, he had recurrent vertigo, vomiting and was hospitalized once because of the association of spinning sensation and severe vomiting during the attack. He was treated with modern medical drugs and physiotherapy with no effort. He still had repeated paroxysmal vertigo but the duration of attack was short. He often felt tired and generalized pain of the bones; he also had yellowish color of urine, poor appetite, palpitation, insomnia, hypochondrial pain and nocturnal urination. Physical examination: pulse104/min, skin dry with desquamation and scaly patches, prominent on the abdominal skin (suffer from dry skin syndrome since childhood), tongue enlarge with teeth prints, abdomen distended, percussion tenderness over hepatic region, hepatomegaly of 1.5 cm, (+) pitting edema of lower extremities. After taking 13 parcels of TCM drugs, his liver returned to normal. During the course of systemic treatment, vertigo disappeared completely. Owing to repeated administration of TCM drugs, the ferment blood level reached normal. Since then, four years elapsed and no episode of vertigo was seen.
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By WONG Kwok Hung
published on 10th July 2001
(translated by Professor ZHENG Hua En in 2003)