The prescription for the treatment of "vertigo": Chai Chen Ze Diarrhea Soup

Wind and fire phlegm is said to be dizzy

Xu, female, 28 years old, cadre, first diagnosed on February 17, 1986.

When the patient was 8 years old, he accidentally fell into the water, was frightened by cold, lay ill for more than a month, and his physical fitness gradually deteriorated. At the age of 11, he suffered from vertigo, dizziness, tinnitus, vomiting, and five or six attacks a year. When he was 20 years old, he ordered 18g of lead powder (6g swallowed in 1 day) to treat vertigo, resulting in acute lead poisoning. After 4 months of lead removal treatment by the Affiliated Hospital of West China Medical University, the main symptoms of lead poisoning disappeared, but the vertigo was significantly aggravated. Patients often feel dizzy, and even feel that the sky is spinning, dare not open their eyes, eyeballs are swollen and painful, vision has a fluttering feeling, tinnitus and ear occlusion, hands and feet tremble, dry nausea and upset.

Western medical diagnosis: inner ear vertigo. He has been treated by traditional Chinese and Western medicine in many hospitals in provinces and cities. Traditional Chinese medicine has used methods such as calming the liver and latent yang, quenching wind and stopping spasms, nourishing the liver and kidneys, strengthening the spleen and dissolving phlegm, and searching for insect drugs to clear the network, taking hundreds of doses, but there is no obvious effect, and often unable to stick to work. Engraving: The symptoms are as above, the tongue is red and moss is thin and white, and the pulse is fine.

Drawing on the unique experience of Jiang Ersun's old Chinese medicine in the treatment of vertigo, it is proposed to diagnose spleen and kidney deficiency, wind and fire phlegm disturbance, try to cast "Chai Chen Ze Diarrhea Soup" flavored: Chai Hu 10g, Shuangqin 6g, Faxia 10g, Codonopsis 15g, Pori Ling 12g, Tangerine Peel 10g, Licorice 3g, Baishu 10g, Ze Diarrhea 30g, Hook Vine 12g (lower back), Chrysanthemum 10g, Tianma 10g (rolled and swallowed), Ginger 10g, White Peony 12g, Raw Oyster 30g.

Effect: After taking 3 doses, dizziness, eyeball swelling, retching, and upset are significantly reduced; Shou Fang took 25 doses, and the symptoms basically disappeared. I have been followed up for 2 years, but I feel dizzy or slightly dizzy when I complain of poor feelings, and I can stop taking two or three doses of this prescription.

【Trainee A】This case has been haunting vertigo for 17 years, and has been poisoned by lead powder, and his body has been poor, which can be called stubborn vertigo, so it has not been effectively treated by Chinese and Western medicine. After the teacher received the treatment, although he did not receive the rapid rest, he was able to abide by the law and abide by the prescription, and finally stopped taking 25 doses, and the effect was still relatively satisfactory. As far as I know, Jiang Lao's self-prepared Chai Chen Ze Diarrhea Soup has been clinically verified in hundreds of cases, and generally taking 2 doses can quickly stop vertigo, which is a highly effective prescription and is worth promoting and using.

However, general vertigo can be quickly relieved by Western medicine, and some can even be relieved on their own.

[Teacher] did have self-remission, but it was seen less clinically. As for the acute and severe cases of vertigo, repeated use of Western drugs such as sedative, diazepam, antiemetic and anticholinergic drugs has little effect, while referrals to Chinese medicine practitioners are not uncommon.

【Trainee B】But there is no equivalence between vertigo in Chinese medicine and vertigo in Western medicine.

【Teacher】What is vertigo? The dazzling person is dizzy, and the dizzy person is dizzy. However, a careful examination of ancient Chinese medicine books and modern textbooks reveals that dizziness, lightheadedness and no feeling of rotation are also included in them, which can only be called vertigo in a broad sense. The vertigo of Western medicine is divided into two categories: "true vertigo" and "false vertigo", which can be called distinct. Its true vertigo, also known as "rotational vertigo", is caused by vestibular nerve or labyrinth lesions of the inner ear, and the clinical manifestations are dizziness, and the feeling of self-rotation, or the rotation of the surrounding scene, accompanied by nausea, vomiting, tinnitus, deafness, nystagmus, headache, ataxia, etc., which are the characteristics of true vertigo.

In view of this, Elder Jiang believes that it is advisable to exclude those who are dizzy, light-headed and have no feeling of rotation from the category of vertigo, so that the name is natural and the dialectic is accurate. It can be seen that Elder Jiang often said that "he can attack jade with the stone of the mountain", that is, borrowing Western medicine for my use, not a cliché.

【Advanced student C】Jiang Lao's name for vertigo is refreshing. But how to use Chinese medicine theory to identify true vertigo?

【Teacher】First of all, we must refer to the theories of previous generations of doctors on vertigo, but when participating in the examination, it should be analyzed specifically, including Ying Tsui Hua, and we must not swallow it alive. For example, theories such as "no wind does not make dizziness", "no fire does not make dazzle", "no phlegm does not make dizziness", "no void does not make dazzle", etc., although each has its own reason, but it is inevitable to lose its bias; And all of them are based on the broad sense of vertigo, if they are moved to explain the etiology and pathogenesis of true vertigo, it is inevitable to lose the generality and abstraction. Elder Jiang believes that it is worth paying attention to Zhang Zhongjing's discussion of vertigo, mostly from the less yang phase to the flame, phlegm and drinking on the reverse theory, mainly using Xiao Chai Hu Tang, Linggui Shu Gan Tang, Ze Epsom Soup, Xiaobanxia Jia Ling Tang, etc., which are quite consistent with some characteristics of true vertigo.

[Trainee C] This is a bit puzzling. First, what is the essential difference between "less yang phase on fire, phlegm drinking on the reverse" and "no phlegm and no dazzle"? Second, if phlegm is a problem, there must be a corresponding tongue vein - tongue greasy, vein string or slippery. But in this case, the tongue is red and mossy and thin, with thin veins.

【Teacher】The phrase "less yang phase fire inflammation, phlegm drinking on the reverse" can deduce the comprehensive etiological pathogenesis of true vertigo - wind, fire, phlegm, deficiency. This is the same as the view of "no phlegm and no dazzle"! According to clinical observations, less yang fire rises, phlegm drinking on the reverse true vertigo, its tongue veins are amorphous. Tongue is greasy, solid is a sign of phlegm drinking, but not greasy or without moss, may not be phlegm drinking. Jiang Lao has treated many patients with vertigo, the tongue is light red and moss is thin white or moss-free, the replenishment of qi and blood is ineffective, and the nourishment of yin and yang is not effective, and he switched to polyester phlegm to drink, driving away wind and clearing fire. Its pulse is amorphous, let alone go into detail. However, the mechanism needs to be further explored.

【Student B】The teacher just said that the phrase "less yang is on fire, phlegm is inverse" can be deduced from wind, fire, phlegm, and void, which is really unheard of, how is it derived?

【Teacher】Shaoyang phase fire and yin wind wood as the surface, wind helps fire, fire helps wind power, always because of each other; The inverse of phlegm drinking is mostly due to spleen and kidney deficiency. You see, isn't this a derivation of the words wind, fire, phlegm, and void? And those who have been well versed in this theory throughout the ages should first recommend Chen Xiuyuan. However, Chen Xiuyuan's discussion of vertigo is centered on the wind, and the solution of fire, void, and phlegm is quite subtle and to the point.

He said, "The wind is not an external wind, it refers to the yin wind and wood", and Muwang is the wind; And because the yin wind wood "cohabits with the fire of the young yang, and the yin qi is reversed, the wind is born and the fire is fired"; The weak one, "the wind will take the wood and conquer the soil", and "the kidney is the liver mother, the kidney is the main essence, and the essence is empty and the head is heavy", that is, the son steals the mother's qi; For phlegm, "soil diseases gather fluid into phlegm." That is to say, wind and fire phlegm is the target of vertigo, and spleen and kidney deficiency are the basis of vertigo. So Chen Xiuyuan concluded, "Those who speak falsely, speak at the root of their illness; Those who speak the truth, speak of their pathologies: Reason is consistent." (Medical Congregation)

Elder Jiang believes that Chen Xiuyuan's argument is very good, and if it is moved to explain the etiology and pathogenesis of true vertigo, it is more accurate. However, Elder Jiang emphasized that the onset of vertigo is not a separate affliction of wind, fire, phlegm, and deficiency, but a combination of them. Therefore, he was quite unimpressed by Zhang Jingyue's statement that "the dizzy one testimony, the virtual one ranks eight or nine, and the one who has both fire and phlegm, but one out of ten and one ear". As far as clinically seen, when vertigo attacks, there is an image of wind and fire phlegm disturbance, can it be explained by "virtual"?

But you can't deny the importance of "virtuality", right?

Of course, [Teacher] cannot deny it, because if it is denied, it will be difficult to satisfactorily explain the signs of wind and fire phlegm. However, Chen Xiuyuan said that deficiency is the root cause of vertigo, can we understand it as "underlying cause" or "physical cause"? However, no matter how it is understood, vertigo is always a comprehensive combination of wind and fire and phlegm, which belongs to the evidence of this fiction, and the treatment should take into account the specimen.

[Trainee C] This is self-evident, but when ancient and modern doctors follow the treatment principle of "treating the symptoms and the root cause", they are colorful in specific treatment, each leading the way, and people are confused. Can the teacher comment on one or two?

【Teacher】It's hard to say enough! Chen Xiuyuan once commented, "The princes of the river, once in the clear fire to drive away the wind and phlegm, still do not know the cause of the wind and fire phlegm." He also said, "Yu Shao read the book of Jing Yue, and he specialized in making up for the false words, obeying it ineffectively, and then searching for the ancient precepts, and then knowing that Jing Yue was in the word false and real, and recognized death, that is, in the word wind and fire, and could not understand the reason for it." ("Medical Follower Record Vertigo") But Xiuyuan treats vertigo, or obeys the method of Danxi, using rhubarb ephemeral fire alone; Or use deer antler wine, flavored Zuogui drink, six-flavor, eight-flavor pills to tonify the kidney; Or use tonic soup to replenish the spleen, and did not taste the symptoms and treat the same thing. Cheng Zhongling and Ye Tianshi proposed the same treatment of the symptoms and the root cause, such as strengthening the spleen, invigorating qi and dissolving phlegm and reducing rebellion, nourishing the liver and kidneys, flattening the liver and latent yang, and being able to reach the right and accessible, which seems to be a good method. However, if it is moved to calm the onset of vertigo, it is still too slow and urgent, and it is difficult to find a quick effect. In recent times, the treatment of vertigo, or the focus on the treatment of the symptoms, such as the reverse treatment from phlegm and liver qi and the use of spinning ochre soup, from the "drinking dizziness" treatment to the use of ze soup, etc.; Or propose warm gallbladder soup for the treatment of the symptoms during the attack period, and ginseng and two Chen soup for the treatment of the root cause in the remission period, etc., all have their own merits and can be used for reference.

【Trainee C】Which one did Jiang Lao take the method?

【Teacher】Jiang Laozhi's testimony is different from the ancient and modern sages, in that he advocated the same treatment of the symptoms and the root cause during his onset, and the medicine of repelling wind and clearing fire and phlegm and tonifying the spleen was put to a rapid end. After the vertigo subsides, the root cause will be treated slowly.

When the original deficiency was investigated earlier, the spleen and kidney were included, why did the specimen only supplement the spleen and not the kidney?

【Teacher】Elder Jiang believes that when vertigo attacks, the signs of phlegm drinking are very obvious, and the medicine that directly tonifies the kidney is not only slow and urgent, but also has the disadvantage of nourishment, but also hindered, and it is difficult to seek quick results. Therefore, it is necessary to wait for the dizziness to stop, and then discuss kidney supplementation. Jiang Lao has repeatedly used six flavors, eight flavors, left gui, right gui, etc. to stop vertigo, but the results have little effect or even no effect. This non-prescription medicine is weak, and it is really untimely to use it. Therefore, Jiang Lao cures the root, and the first thing is more important than the spleen. And the so-called replenishment of the spleen is not a dull supplement, but a transport of the spleen and stomach. Because the spleen can dissolve phlegm and drink, and the stomach can stop vomiting; The spleen can protect the liver, and the wind and wood must not be crossed; The wind and wood are quiet, and the fire is peaceful. In this way, the signs of wind and fire phlegm disturbance can be quickly eliminated. It can be seen that this is a direct treatment of the root cause and an indirect treatment of the symptoms, killing two birds with one stone.

【Intern】I want to know the drug composition, common dosage, solution and scope of use of Chai Chenze Epsom Soup.

【Teacher】Chai Chen Ze Epsom Soup is a combination of Xiao Chai Hu, Er Chen and Ze Epsom Soup, plus Tianma, hook vine and chrysanthemum. Medicinal use: Chaihu 10g, Skullcap 6-10g, Faxia 10g, Codonopsis 12-15g, Licorice 3-5g, Jujube 10-12g, Ginger 6-10g, Tangerine Peel 10g, Pori 15g, Baishu 10-15g, Ze Epsom 10-15g, Tianma 10g (rolled and swallowed), hook vine 12g (lower back), chrysanthemum 10g. Among them, Xiao Chai Hu Tang rotates the cardinal Shaoyang, penetrates the Yuhuo, rises and clears and lowers turbidity; 2. Chen decoction dissolves phlegm and decreases; Ze Epsom soup cleansing water. Fang Zhong still has a small half of Xia Jia Ling soup, which can also reduce phlegm, drink and stop vomiting; There is also six gentlemen's soup, which transports the spleen and stomach to cure the root. Those who add gastrodia, hook vine and chrysanthemum are designed to soften and quench the liver wind.

According to the principle of "same treatment for different diseases", the scope of use of this party can be expanded. For example, vertigo caused by high blood pressure or cerebral artery insufficiency, as long as it has the characteristic symptoms of true vertigo, it can also be quickly stopped. In addition, my recent treatment of vertigo caused by cervical spondylosis is to remove tangerine peel, poria, licorice, hook vine, chrysanthemum, and re-add 30-60g of kudzu root to lead the jin liquid to relieve muscles and slow down spasms; Then add Chuanxiong 30-45g to activate blood circulation and remove stasis, and relieve pain. More than 10 cases have been observed, and their recent efficacy is satisfactory.

Note: This experience can be referenced, please use it under the guidance of a professional physician above!