A 32-year-old woman had been suffering from migraine for the past 8 years. The headaches occurred on the top of the head and behind the eyes. They started with a dull pain and increased in intensity to a severe character, accompanied by nausea, vomiting and diarrhoea. They were better lying down. By the time she sought treatment, they occurred almost every day. Her tongue was Pale and Thin, and her pulse was Weak on the right side and slightly Wiry on the left.
Liver-Yang rising stemming from LiverBlood deficiency. The Liver-Blood deficiency is apparent from the Pale and Thin tongue and Weak pulse. The dullness of some of the headaches and the fact that they are improved by lying down indicates that they are due to a deficiency, in this case of LiverBlood. The location of the headaches on top of the head also indicates Liver-Blood deficiency. Liver-Yang rising accounts for the more severe headaches and the vomiting and diarrhoea, due to Liver-Qi invading Stomach and Spleen, preventing Stomach-Qi from descending (vomiting) and Spleen-Qi from ascending (diarrhoea).
Nourish Liver-Blood and subdue Liver-Yang. In this case, although the severe headaches are due to Liver-Yang rising, the pattern is still primarily one of deficiency, as evidenced by the tongue. For this reason, the treatment was aimed primarily at nourishing Liver-Blood.
The main points used were P-6 Neiguan, T.B.-4 Yangchi, ST-36 Zusanli, LIV-8 Ququan, SP-6 Sanyinjiao and LIV-3 Taichong.
The first two points were used with even method, LIV-3 was reduced and all the others were reinforced. Warming needle was applied to ST-36.
• P-6 was used to regulate Liver-Blood, calm the Mindand settle the Ethereal Soul.
• T.B.-4 was used in conjunction with Neiguan P-6 asa combination of Connecting and Source point. This combination strengthens the effect of P-6, while it also regulates the Lesser Yang channels. In addition, Yangchi T.B.-4 has a general tonifying effect.
• ST-36 and SP-6 were used to nourish Blood.
• LIV-8 was used to nourish Liver-Blood.
• LIV-3 was used to subdue Liver-Yang.
The prescription used was a variation of Si Wu Tang Four Substances Decoction to nourish Liver-Blood. This prescription was chosen in preference to one of those to subdue Liver-Yang, because the condition was deemed to be primarily one of deficiency (of Liver-Blood). Herbs were added to subdue Liver-Yang. The prescription used was:
• Dang Gui Radix Angelicae sinensis 9 g
• Bai Shao Radix Paeoniae alba 6 g
• Chuan Xiong Rhizoma Chuanxiong 6 g
• Shu Di Huang Radix Rehmanniae preparata 6 g
• Shi Jue Ming Concha Haliotidis 9 g
• Gou Teng Ramulus cum Uncis Uncariae 6 g
• Man Jing Zi Fructus Viticis 4 g
• Ju Hua Flos Chrysanthemi 3 g
The first four herbs are the Si Wu Tang Four Substances Decoction to nourish Liver-Blood.
Shi Jue Ming, Ju Hua and Gou Teng were added tosubdue Liver-Yang.
Man Jing Zi was added to treat the headaches.
This patient had a remarkable improvement after only one treatment, and her headache more or less went after three acupuncture treatments and three courses of 10 decoctions each.