Angioneurotic Headache

Case 1
Name: Zhu.
Sex: Male.
Age: 42 years.
0ccupation: A driver.
Chief Complaint: Dizziness and headache for more than 3
years.
History of Present Illness: More than 3 years ago, the patient
got dizziness and headache slowly, it's a constant dull pain
located in the right parietotemporal region and could be easily
turned into a sharp prickling like pain by catching a cold; the
dizziness occurred paroxysmally, usually it was induced by
severe headache. In the past 3 years, the above syndrome got
sometimes mild and sometimes severe. After many times'
treatment of Western medicine, TCM, acupuncture and
massage, the sickness could not be cured completely yet.
During the treatments, his dizziness and headache got mild,
while the treatments finished, the syndrome became as same
as before. Sometimes the bad headache prevented him from
working on. On December 8,1999, when he was driving, the
severe headache made he couldn't drive on. Then he came to
our hospital for treatment.
Physical Examination: The patient was conscious with a normal
general condition. The pulse was taut, thready and uneven, the
tongue was red with a thin layer of white fur. The shape of head
was normal. There wasn't tenderness in the affected region.
There was not other abnormal sign.
Diagnosis: Angioneurotic Headache.
Differentiation: It's stagnation of qi in liver channel, which
caused qi stagnation and blood stasis in the meridian of the
head. In addition, exogenous pathogenic wind and cold
attacked the body from the exterior and got into the
superficies, which resulted in obstruction of meridian qi at the
top of head. So that the patient got the severe headache.
Therapeutic Principle: Relieving of secondary symptoms in
emergency while treatment of chronic disease aiming at the
principal aspect. Because there was a sharp prickling-pain
currently, it's necessary to use acupuncture to dredge the
obstructed meridian passage and relieve the pain quickly. In
addition, because this sickness was a chronic illness of many
years, curative effect of using Chinese herbs and acupuncture
would not persist for a long term, then it's necessary to use
medicinal liquor to keep a long time of curative effect. Only by
this way, could the inveterate illness be cured completely.
Acupuncture Method: I pricked the point of Yemen(TE2) with a
1.5 cun needle, manipulating the needle with reducing skill.
After 1 time's acupuncture, the sharp prickling pain disappeared at once, only dizziness and distending sensation of
head were there. Then he was told to make the medicinal
liquor. The prescription of medicinal liquor was as follow.
Recipe:
JinQianBaiHuaShe,Multibanded Krait 8 ones
QiShe,I.ong-noded Pit Viper 15g
WuShaoShe,Black-tail Snake 15g
ChuanShanJia,Pangolin Scale 15g

DiBieChong,Ground Beetle 20g

QuanXie, Scorpion 15g
WuGong, Centipede 15g
QiangHuo,Notopterygillm Root 25g
JiXueTeng,Spatholobus Stem 60g
GaoBen,Ligusticum Root 25g
GouQiZi,Wolfberry Fruit 30g
XiXin,Asarum Herb 25g
HuangQi,Milkvetch Root 60g
DangGui,Chinese Angelica Root 25g
FangFeng,Ledebouriella Root 20g
ChuanXiong,Chuanxiong Rhizome 30g
ShuDiHuang,Prepared Rehmannia Root 90g
TianMa,Gastrodia Tuber 30g
GouTeng, Hooked Unearia 30g
YuanZhi,Polygala Root 20g
ShiChangPu,Grassleaved Sweetflag Rhizome 20g
All the above drugs were to be soaked into 3kg of spirit
distilled from sorghum. The wine jug was sealed hermetically. 2
months later, it's the time to begin drinking the medicinal
liquor, only 1 little cup of the liquor each time,2 times a day.
Effect Observation: After half a month of taking the medicinal
liquor, there were not the dizziness, headache and the
distending sensation of head. Then the patient was told to
continue taking the medicinal liquor. After 1 year' s follow-up,
the sickness didn' t recur. Then it' s ending.
Case 2
Name: Wang.
Sex: Male.
Age: 46 years.
0ccupation: A woodworker.
Chief Complaint: Headache for 25 years.
History of Present Illness: Twenty-five years ago, the patient
got a headache without any obvious causes. It occurred
intermittently and was often induced by overwork or mental
tension. When the attack came on, the patient got a distending
pain and a sensation of bursting in the both sides of
0ccipitotemporal region, it seemed that his scalp was
constricted. It severely prevented him from normally working
and living. After the illness came on, he asked innumerable
doctors for treatment and was separately treated with
"Piminodine, Brufen, Carbamazepine Pills of Gastrodiae" and so
on, the pain was
relieved. But in recent 2 years, the recurrence of the illness got
more and more in frequency, and the affected region was
extended from both occipitotemporal part to forehead. Once
the attack recurred, the headache was so sharp that he couldn't
stand it. Then he came to our hospital for treatment on March
20,1998. In addition, the patient usually got dry mouth and
annoy. His stool was dry and cositive, it was moved once every
2 or 3 days, his urine was yellow and scanty, his appetite and
sleeping were all normal.
Physical Examination: The patient was conscious with a normal
general condition. The pulse was taut and floating. The tongue

was dark red with a thick layer of dry yellow fur. The shape of
the head was normal. There wasn't other abnormal sign.
Diagnosis: Angioneurotic Headache.
Differentiation: It belongs to the category of "PianTouTong"
(migraine) in TCM. Because the affected parts were located in
0ccipitotemporal part and forehead, it belonged to "YangMing
Headache" and "ShaoYang Headache. "In addition, the pulse
and the tongue reflected there was stagnant heat in the interior
organ.
Therapeutic Principle: Expelling evils both in the superficies and
the interior, expelling superficial evils and clearing away heat
together.
Recipe: Miraculous Bolus of Ledebouriellae.
FangFeng,Ledebouriella Root 15g
JingJie, Schizonepeta 15g
I.ianQiao,Forsythia Fruit 15g
MaHuang, Ephedra 15g
BoHe,Peppermint Herb 15g
ChuanXiong,Chuanxiong Rhizome 15g
DangGui,Chinese Angelica Root 15g
BaiShao,White Peony Root 15g
BaiZhu,Bighead Atractylodes Rhizome 15g
ZhiZi,Parched Capejasmine Fruit 15g
JiuDaHuang,Rhubarb 15g (fried with spirit)
MangXiao, Mirabilite 15g
ShengShiGao, Gypsum 30g
HuangQin,Scutellaria Root 30g
JieGeng,Platycodon Root 30g
HuaShi, Talc 50g
GanCao,Liquorice Root 30g
The above drugs were ground together into powder and
mixed with water to make pills. 8g of the pills were taken each
time,3 times a day. Greasy and hot food was forbidden during
the treatment.
Effect Observation: After 10 days' treatment, the headache was
relieved greatly, there wasn't pain in forehead and both sides of
occipitotemporal regions. After half a year's follow up, the
illness didn't recur. Then it's ending.
Case 3
Name: Wang.
Sex: Female.
Age: 68 years.
0ccupation: A peasant.
Chief Complaint: Headache and dizziness for 12 years.
History of Present Illness: Twelve years ago, the patient got
headache and dizziness without any obvious causes. It's a
constant dull pain, accompanied with a heavy sensation of the
head; once it was raining or overcast, or she was overworking,
the above symptom was aggravated. Sometimes the
aggravated headache could become a sharp prickling like pain,
accompanied with a sensation of numbness on her face, the
affected region wasn't limited. Furthermore, there was an
involved aching-pain in the neck and back, which prevented her
from holding up the right arm as normal. If she tried holding up

her right arm, she would get an insufficient pain immediately.

After many times of treatment in the local hospital, there was
little curative effect on her. Then she came to our hospital for
treatment on January 18, 1996.
Physical Examination: The patient was spiritless with a weak
general condition. She got lassitude and fatigue. The pulse was
floating and taut, the tongue was red with a thick layer of
watery fur. The shape of the head was normal. There was a
sharp tenderness on the left region and the top of the head,
where couldn't be pressed because of the sharp tenderness.
There wasn't other abnormal sign.
Diagnosis: Angioneurotic Headache.
Differentiation: This disease, in TCM, belongs to the category of
"TouFeng, PianTouTong ( head wind syndrome, migraine) ". It
was caused by upward retention of phlegm-dampness in head
and deficiency of liver and kidney. As a result of deficiency of
liver and kidney, there was hyperactivity of asthenic liver-Yang,
which was reflected by the taut pulse and the red tongue; as a
result of upward retention of phlegm-dampness in head,
there were dizziness, lassitude and fatigue. In addition, there
was attack of exogenous pathogenic wind and cold from the
exterior, which was reflected by the involved aching-pain in the
neck and the back and the floating pulse.
Therapeutic Principle: Eliminating phlegm-dampness and
calming hyperactivity of liver-Yang, nourishing liver and kidney,
activating blood and resoling blood-stasis.
Recipe:
ShuDiHuang,Prepared Rehmannia Root 30g
BaiShao,White Peony Root 30g
HuangQi,Milkvetch Root 30g
DangGui,Chinese Angelica Root 15g
GouQi,Wolfberry Fruit 25g
YuanZhi,Polygala Root 20g
ShiChangPu,Grassleaved Sweetflag Rhizome 20g
ZhiFuZi,Prepared Aconite Root 12g
QiangHuo,Notopterygillm Root 20g
GaoBen, Ligusticum Root 15g
DiLong, Earthworm 15g
BaiJiangCan,Batryticated Silkworm 15g
ChuanXiong,Chuanxiong Rhizome 20g
HongHua, Safflower 10g
GanCao,Liquorice Root 10g
All the above drugs were to be decocted in water for oral
taking. 5 doses were prescribed.
Effect Observation: After taking the decoction, the patient
came back and said the involved aching-pain in the neck and
back had disappeared, she could hold up the right arm freely
while the headache was as same as before, and there were
abdominal distending and anorexia. Physical examination
showed the pulse was thready and taut, the tongue was red
with a greasy layer of white fur. Then the differentiation should
be hyperactivity of liver-Yang and retention of dampness, which
caused a failure of spleen to transportation and transformation.
The corresponding therapeutic principle should be
strengthening the curative effect of eliminating pathogenic
damp phlegm and soothing the hyperactive liver-Yang. Recipe :

DangShen,Pilose Asiabell Root 30g

ShuDiHuang,Prepared Rehmannia Root 25g
ShaYuanZi,Flatstem Astragalus Seed 25g
GouQiZi,Wolfberry Fruit 25g
QuanXie, Scorpion 10g
WuGong, Centipede 10g
GouTeng, Hooked Uncaria 15g
TianMa,Gastrodia Tuber 20g
YiYiRen,Coix Seed 30g
CangZhu,Atractylodes Rhizome 20g
ZhiNanXing,Arisaema with Bile 12g
HongHua, Safflower 10g
ChuanXiong,Chuanxiong Rhizome 15g
GanCao,Liquorice Root 10g
All the above drugs were to be decocted in water for oral
taking. 5 doses were prescribed.
Effect Observation: After taking the decoction, the dizziness
and headache disappeared, the abdominal distending and
anorexia disappeared too. There was not other uncomfortable
sensation. After half a year's follow-up, the sickness didn't
recur. Then it's ending.
Case 4
Name: Ma.
Sex: Female.
Age: 30 years.
0ccupation: A worker.
Chief Complaint: Headache and dizziness for half a month.
History of Present Illness: Half a month ago, the patient got a
headache without any obvious causes, it was a continuous
distending-pain and located in both parietotemporal regions. It
seemed that the scalp of the affected regions was constricted
by a hoop, it caused she got an insufferable distending-pain in
the head. Usually the headache was accompanied with
dizziness, bitterness of mouth, dryness of throat and
distending-pain of breasts. Furthermore, there were distending
pain of eyes, burning sensation of eye-sockets and hectic fever
of both cheeks. Then she went to the department of internal
medicine of a hospital for treatment, she was treated with oral
medicating "Brufen, Capsul of Gastrodiae. " After half a month's
treatment, her suffering from the illness couldn' t be relieved
yet. Then she came to our hospital for treatment on December
25,1999.
Physical Examination: The patient was conscious with a hectic
complexion. The pulse was taut and rapid, the tongue was dark
red with a thin layer of white fur. The shape and structure of
the head were all normal. There was no abnormal sign in the
both parietotemporal regions. No tenderness could be found in
the affected regions. The movement of the neck was not
limited. There wasn't other abnormal sign.
Diagnosis: Angioneurotic Headache.
Differentiation: It's hyperactivity of liver-Yang, which caused
the up-flaming of deficiency-fire and fled along Foot Jueyin
Liver Channel. As a result of it, a special phenomenon arose:
where the Jueyin Liver Channel extends, there was suffering

from the illness. The liver channel extends upward through the
breast, then there was distending-pain in the breast; the liver
channel surrounds the eyes and is associated with the eyes as
its orifices, then there were a sensation of burning in the eyesockets and a distending-pain in the eyes; the liver-channel
extends upward through the parietotemporal regions and ends
at the top of the head, then there was a distending pain in the
parietotemporal regions and the top of the head. This
phenomenon is the typical syndrome of the evil's fleeing along
the channel.
Therapeutic Principle: Clearing away heat to cool blood;
expelling the heat evil in the organs by taking purgative herbs;
soothing liver to relieve depression; activating blood to resolve
stasis; relieving the superficies-syndrome with pungentflavored and cool-propertied herbs; sending the asthenic fire
downward.
Recipe:
ShengDiHuang,Dried Rehmannia Root 15g
MuDanPi,Tree Peony Bark 12g
HuangI.ian,Coptis Root 6g
HuangQin,Seutellaria Root 6g
YuanHu,Corydalis Tuber 9g
ChaiHu,Bupleurum Root 8g
TaoRen,Peach Seed 12g
HongHua, Safflower 12g
ChiShao,Red Peony Root 12g
NiuXi,Achyranthes Root 18g
ZhiKe,Fruit of Citron 12g
ShanZhi,Capejasmine Fruit 9g
ChuanXiong, Chuanxiong Rhizome 12g
BoHe,Peppermint Herb 12g (to be decocted later)
ShengDaHuang,Raw Rhubarb 9g (to be decocted later)
All the above drugs were to be decocted in water for oral
taking. 5 doses were prescribed, taking the decoction in
morning, afternoon and evening separately.
Effect Observation: After taking the 1st dose, the headache
disappeared at once, the dizziness was relieved greatly; after
taking the 3rd dose, all the uncomfortable sensation
disappeared; after taking the 5th dose, the patient was in
health. Then she was to1d to take 2 doses of the original
prescription again to make pills, take 6g of the pills each time,3
times a day. She should take the pills in order to keep a long
time of curative effect. After halt a year's follow up, the illness
didn't recur. Then it's ending.