Dizziness Xuan Yun Due To Liver Yang Rising, Liver Fire

Front 1

Dizziness due to Liver Yang Rising, Liver Fire

Pathophysiology

Back 1

In pure forms these are EXCESS patterns.
In younger people this is a common cause.
Relationship between qi stagnation, Liver Yang or Fire and Liver Yin deficiency with rising Yang is such that often there are elements of all three.

In this pattern Liver Yang rises when stagnant Qi is suddenly released (like a cork).
Both patterns are a sudden release of pent up Qi but Fire is hotter and dryer and may cause haemmorrhage. Liver Fire is more likely if Internal Heat already exists or severe aetiological conditions.
Fire is exacerbated by a diet rich in heating foods and alcohol.

Front 2

Dizziness due to Liver Yang Rising, Liver Fire

Clinical Features

Back 2

-Dizziness and vertigo, which maybe severe and initiated or aggravated by stress, anger or emotional upset
-Headache or fullness and distension in head and eyes
-Blurring vision, res, sore, gritty eyes.
-Irritability, temper outbursts
-Red complexion or facial flushing
-Insomnia with much dreaming
T-Red edges with a thin yellow coat
P-Wiry and Rapid

Front 3

Dizziness due to Liver Yang Rising, Liver Fire

Treatment Principle
&
Prescription

Back 3

TP: Calm the Liver and Subdue Yang
Clear Heat and extinguish Wind
RX: TIAN MA GOU TENG YIN modified
Tian Ma 9
Gou Teng 9 (at end)
Shi Jue Ming 15 (+30mins)
Xia Ku Cao 15
Fu Shen 15
Ye Jiao Teng 15
Sang Ji Sheng 15
Du Zhong 15
Niu Xi 12
Ju Hua 12
Shan Zhi Zi 12
Huang Qin 9

Front 4

Dizziness due to Liver Yang Rising, Liver Fire

Modifications
With Liver Fire
Clinical Features
Treatment Principle
Prescription

Back 4

Casuing severe headaches
red, sore distended eyes
dark urine
T-Red with thick dry yellow coating
P-Wiry and Rapid

TP: Clear the Liver and Drain FIRE.

TIAN MA GOU TENG YIN
+ Long Dan Cao 9
Mu Dan Pi 12

or use
LONG DAN XIE GAN TANG
Long Dan Cao 6
Huang Qin 6
Shan Zhi Zi 6
Ze Xie 6
Mu Tong 6
Che Qian Zi 9
Dang Gui 6
Sheng Di Huang 6
Chai Hu 6
Sheng Gan Cao 3

Purges excessive fire of the LV and GB, clears D-H in lower Jiao.

Front 5

Dizziness due to Liver Yang Rising, Liver Fire

Modifications for:
-with constipation

Back 5

Constipation:
TP: Clear LV and Bowels
+ Da Huang 6-9
+ Mang Xiao 6
or + DANG GUI LONG HUI WAN
Dang Gui 30
Long Dan Cao 15
Zhi Zi 30
Huang Lian 30
Huang Qin 30
Lu Hui 15
Da Huang 15
Mu Xiang 4.5
She Xiang 1.5
Sheng Jiang

Front 6

Dizziness due to Liver Yang Rising, Liver Fire

Modifications for:
-with mild yin deficiency
-with Liver Wind (and features)

Back 6

-Mild Yin Deficiency
Add 2 or 3 of the following:
Mu Li 15
Gui Ban 12
Bie Jia 12
He Shou Wu 12
Sheng Di 15

-With Liver Wind
severe dizziness and tinnitus
vomiting, numbness in the extremities, tics, tremors, fasiculations and spasms
TP: Calm the Liver and Suppress Wind.
+ Long Gu 15
Mu Li 15
Zhen Zhu Mu 15

Front 7

Dizziness due to Liver Yang Rising, Liver Fire

Variation
If Wind becomes the main concern

Back 7

TP: Clear Liver Heat and Extinguish Wind (see also Stroke)
RX: LING YANG JIAO TANG modified
Ling Yang Jiao Fen 4 (+ to strained decoction)
Gou Teng 12 (towards end)
Shi Jue Ming 18
Gui Ban 15
Xia Ku Cao 15
Sheng Di 15
Huang Qin 9
Niu Xi 15
Bai Shao 15
Mu Dan Pi 12

Front 8

Dizziness due to Liver Yang Rising, Liver Fire

Patent Medicines

Back 8

TIAN MA GOU TENG YIN
sang ji sheng, shi jue ming, gou teng, ye jiao teng, fu ling, niu xi, yi mu cao, tian ma, shan zhi zi, du zhong,
YANG YIN JIANG YA WAN
he shou wu, jue ming zi, bai shao, fu ling, du zhong, ze xie, niu xi, shi hu, gou teng, yu mi xu, yuan zhi, ju hua
LONG DAN XIE GAN WAN
long dan cao, chai hu, ze xie, sheng di, shan zhi zi, huang qin, che qian zi, mu tong, dang gui, gan cao
HU PO BAO LONG WAN
hu po, tian zhu huang, tanxiang, ren shen. fu ling, gan cao, zhi shi, zhi qiao, shan yao, zhu sha, dan nan xing, jin bo

Front 9

Dizziness due to Liver Yang Rising, Liver Fire

Acupuncture

Back 9

Gan Shu BL-18 (-)
Tai Chong LV-3 (-)
He Gu LI-4 (-)
Qu Chi LI-11 (-)
Feng Chi GB-20 (-)
Xia Xi GB-43 (-)
Tou Wei ST-8
Shen Shu BL-23 (+)
Yin Tang M-HN-3

With Fire:
Xing Jian LV-2 (-)
With hypochondriac pain:
Yang Ling Quan GB-34 (-)
Zhi Gou SJ-6 (-)
With severe insomnia and dream distrubed sleep:
Shenmen HT-7
San Yin Jian SP-6

Front 10

Dizziness due to Liver Yang Rising, Liver Fire

Clinical Notes

Back 10

This pattern maybe associated with hypertension, TIA's, impending stroke, eclampsia, puerperal fever or Meniere's disease.

This pattern can represent a potentailly dangerous situation or an impending catastrophe.
Acupuncture with strong stimulation can be effective in the case of impending stroke or dangerously high BP.
Persistent high BP that does not respond to TCM treatment should be investigated medically.