Medical Dialogue
医学会话
Syndrome and Treatment of Dizziness and Vertigo
眩晕的辨证和治疗
Professor Kristine Buetski is a teacher at an acupuncture college in the U.S. Her student Michael Bradwin is having trouble understanding the professor's lecture. He's asking for some help in understanding the subject of dizziness and vertigo.
| professor: | So, Michael, you looked like you were having trouble with the lesson today. What was confusing you? |
| student: | I wasn't really sure about all the types of patterns with dizziness and vertigo. Also I'm not really sure what the difference is between dizziness and vertigo. |
| professor: | Dizziness is the feeling that you are about to faint or "pass out". Although you may feel dizzy, you do not feel as though you or your surroundings are moving. Vertigo is the feeling that you or your surroundings are moving when there is actually no movement. You may feel as though you are spinning, whirling, falling, or tilting. Regardless of the slightly different meaning of these two problems, the patterns of disharmony are similar for both. |
| student: | Thanks, that makes sense. But, how many patterns are there? |
| professor: | There are six common patterns and two occasional ones. Can you name any of them? |
| student: | I think I can name a few. First, there is deficiency of qi and blood. |
| professor: | Very good! How would you treat that with acupuncture? |
| student: | Well, do you want me to tell you points that treat blood deficiency or points to treat qi deficiency? |
| professor: | We say that "blood follows the qi". So, what do you think? |
| student: | I think good points to use are LI4, ST36, CV12, SP6 and 10, PC6, HT6 and 7, KI3, and BL17 and 20. |
| professor: | Very good! What other types of patterns are there? |
| student: | I believe there is deficient kidney essence, yin and yang. |
| professor: | Great! What acupuncture points would you use in those situations? |
| student: | For kidney essence GV4 and 14, BL23, KI3 and GB39. Plus, burning moxa on GV4 would help too. |
| professor: | Very good! What about kidney yin and yang deficiency? |
| student: | For kidney yin deficiency I would use KI3, 6, 9, LU7 and CV6 and 4. |
| professor: | Your point selection is very thorough. What would be the point prescription for the kidney yang? |
| student: | Let me think. Moxibustion on CV4, and needle KI3, 6, 9, SP6 and LU7. Is that right? |
| professor: | Yes, all those points would help with kidney yang deficiency. Now, are you sure you understand the differences between kidney yin, kidney essence and kidney yang deficiency? |
| student: | I think so. Kidney essence is the essence of the body. It's what helps build our constitution. It's made up of our pre-natal qi and post-natal qi basically. |
| professor: | What are its clinical manifestations? |
| student: | The basic symptoms for kidney essence deficiency are soreness and weakness of the lower back, weak knees, frequent urination, shortness of breath, premature aging, poor memory, sexual dysfunction, infertility and slow mental or physical development. |
| professor: | How about kidney yin deficiency? |
| student: | Kidney yin provides energy for the physiological functions of the body. If there is a deficiency in the kidney yin the symptoms are dizziness, tinnitus, blurred vision, malar flush, five center heat, poor memory, constipation, afternoon fever, weakness of the legs, and nocturnal emission. |
| professor: | Could you describe kidney yang insufficiency? |
| student: | Certainly. Kidney yang promotes storage of kidney yin and warms the body. If there is deficiency of kidney yang, then symptoms include aching and coldness of the lower lumbar region and knee joints, chillness, diarrhea, impotence, edema of the lower limbs, deafness and dizziness. |
| professor: | Excellent, you're a fast learner. Now what are the other patterns that can cause dizziness and vertigo? |
| student: | I'm not really sure. |
| professor: | Well, there are really only four more patterns and two of these are more common than the other two. |
| student: | What are they? |
| professor: | Liver yang hyperactivity can cause dizziness; symptoms would include anger, depression, headache, dizziness, tinnitus and vision problem (e.g. dry red eyes). Now, what points would you use to treat this condition? |
| student: | The best points for liver yang hyperactivity would be LR2, GB8, 20 and 38, PC6, SP6 and ST36. |
| professor: | That's right. A less common pattern is liver fire. We won't discuss that today. However, another important pattern is phlegm and dampness in the middle burner. What are the common symptoms of this syndrome? |
| student: | Other than dizziness and vertigo? |
| professor: | Yes. You could say this if you are looking for some humor but not sure this is what you want. |
| student: | Sometimes a patient might have nausea, vomiting, poor appetite, a feeling of heaviness in the chest and epigastrium and loose stools. |
| professor: | Right on the money there! Now, what would be the points to use? |
| student: | ST40, 36, SP9, CV9 and 10. |
| professor: | Seems like you have been paying attention in class. Now, the last pattern is wind heat which is fairly rare and we won't talk about that now. Do you have any more questions? |
| student: | No, sir, that about covers it. Thanks, for all your help. |
| professor: | Don't mention it. See you next week. |