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8 Cards in this Set

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Dizziness due to Liver and Kidney Yin Deficiency with Yang Rising

Pathophysiology
A mixed pattern of deficient Yin leading to excess Yang. The LV and KI deficiency is the predominant pattern. LV Yin deficiency often follows chronic conditions involving rising Liver Yang or Fire, or stagnant Heat.
More common in older people.
The mechanism of rising yang is different here than in Liver Yang/Fire rising. In simple Yang rising; pent up qi eventually creates enough pressure to pop the cork. In this pattern LV and KI Yin are deficienct and are insufficient to anchor Yang and provide counterweight to its active and rising nature. when anchoring Yin reaches a critical point of deficiency the Yang loses its mooring and becomes excessiviely mobile; RISING TO THE HEAD. When Rising Yang reaches a certain level of intensity (sufficient to cause loss of balance or collapse) it may be redefined as Wind.
Dizziness due to Liver and Kidney Yin Deficiency with Yang Rising

Clinical Features
-Dizziness which is generally mild, with occasional exacerbations in severity that maybe triggered by stress, overexertion, emotional upset, sexual activity or heating foods and alcohol.
-Blurring vision or visual disturbances, pressure behind the eyes.
-Irritability and restlessness
-Headache-often temporal
-Insomnia or restless sleep with many dreams
-facial flushing, malar flush, night sweats
-five palm heat
-tinnitus
-weakness, fatigue
-lower backache
T- red and dry with little or no coat
P- Wiry, thready and rapid
Dizziness due to Liver and Kidney Yin Deficiency with Yang Rising

Treatment Principle and Prescription
TP: Nourish Yin, Sedate the Liver, Anchor Yang (Subdue Wind).

RX: ZHEN GAN XI FENG TANG
*LV & KI def. with Yang rising hypertension and pre-stroke conditions. Suitable for long-term use, although a more specific LV and KI Yin Tonic may be selected when rising Yang is sedated.
Huai Niu Xi 30
Dai Zhe Shi 30
Long Gu 15
Mu Li 15
Bai Shao 15
Gui Ban 15
Tian Dong 15
Xuan Shen 15
Mai Ya 12
Chuan Lian Zi 6
Qing Hao 6
Gan Cao 5
Dizziness due to Liver and Kidney Yin Deficiency with Yang Rising

Modifications for:
-Chronic Headaches
-Hypertension
-Significant KI Def.
-Constipation
Chronic Headaches:
+ Dan Shen 15
Chuan Xiong 6

Hypertension:
+ Xia Ku Cao 15
Gou Teng 12
Ju Hua 9
Di Long 9

Significant KI Def:
+ Shu Di 18
Shan Zhu Yu 12

Constipation:
delete Dai Zhe Shi
+ Chi Shi Zhi 15
Dizziness due to Liver and Kidney Yin Deficiency with Yang Rising

Follow up treatments
When symptoms are under control, use a YIN NOURISHING RX such as:
QI JU DI HUANG WAN
shu di, shan zhu yu, shan yao, fu ling, ze xie, mu dan pi, gou qi zi, ju hua
or
ZHI BAI BA WEI WAN
shu di, shan zhu yu, shan yao, fu ling, ze xie, mu dan pi, zhi mu, huang bai
to nourish LV and KI Yin.
Dizziness due to Liver and Kidney Yin Deficiency with Yang Rising

Patent Medicines
QI JU DI HUANG WAN
shu di, shan zhu yu, shan yao, fu ling, ze xie, mu dan pi, gou qi zi, ju hua
ZHI BAI BA WEI WAN
shu di, shan zhu yu, shan yao, fu ling, ze xie, mu dan pi, zhi mu, huang bai

MING MU DI HUANG WAN
shu di, shan zhu yu, shan yao, fu ling, ze xie, mu dan pi, gou qi zi, ju hua, bai shao, bai ji li, gou teng, dang gui, gan cao
ER LONG ZUO CI WAN
shu di, shan yao, fu ling, mu dan pi, chai hu, shan zhu yu, ze xie, wu wei zi
TIAN MA GOU TENG WAN
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, yi mu xu, yuan zhi, ju hua
Dizziness due to Liver and Kidney Yin Deficiency with Yang Rising

Acupuncture
Shen Shu BL-23 (+)
Tai Xi KI-3 (+)
San Yin Jiao SP-6 (+) (5 Palm Heat)
Tai Chong LV-3
Xin Shu BL-15
Yong Quan KI-1
Nei Guan PC-6 (5 palm heat)
Ting Hui GB-2
Shen Men HT-7
Zhao Hai KI-6
Gan Shu BL-18
Dizziness due to Liver and Kidney Yin Deficiency with Yang Rising

Clinical Notes
This pattern maybe associated with Hypertension, menopausal syndrome or TIA's.

May respond well to correct and prolonged treatment, but unresponsive or persisitent High BP must have further nvestigation.