Wu Zhu Yu Tang and Ling Gui Zhu Gan Tang Plus Ban Xia Pattern to treat Migraines

Clinical case reviewed in 2015 SHL webinar 5 with Dr. Feng

 

Ms. Xue, 26 years old

1st consultation on January 7th, 1967

The patient suffered from left-sided headaches for 6-7 years, she received many treatments in Chang Chun but none seemed to work. In the recent year her episodes became more frequent and so, carried by her friend she came to consult prof. Hu.

 

Symptoms at consultation: Almost daily headache episodes, mostly affecting the left side above Tai Yang (EX-HN 5) acupoint, sometimes lighter and sometimes more severe, accompanied by nausea, vomiting or diarrhea, restricting her to her bed for 4-5 days, when the pain was severe it would spread to the face, often accompanied by dizziness, aversion to cold, white tongue coating which was greasy at the root and a deep, thready pulse.

 

The daily headache, aversion to cold are the Tai yang syndrome and the nausea, vomiting, diarrhea, are the Tai yin. What is interesting and we can see here is the combination of exterior interior syndrome of the Tai yang Tai yin when the upsurging of qi causes the internal rheum to move upward and cause dizziness.

 
Six syndrome: Tai yang Tai yin concurrent syndrome

Formula pattern: Wu Zhu Yu and Ling Gui Zhu Gan plus Ban Xia Tang pattern

Wu Zhu Yu 12g Dang Shen 10g Sheng Jiang 10g
Da Zao 4 pcs Gui Zhi 10g Bai Zhu 10g
Fu Ling 10g Zhi Gan Cao 6g Ban Xia 12g

 

Result: After taking 3 packs, her headaches reduced and were less frequent, she no longer suffered from nausea or vomiting. After 6 further packs her syndrome subsided altogether.

 

SHL Clause 387 reads:

“If there is dry retching with salivation and headaches, Wu Zhu Yu Tang governs.”

《伤寒论》387:“干呕吐涎沫、头痛者,吴茱萸汤主之”。

 

Analysis: This describes the treatment of internal deficiency cold rheums rushing upwards with Wu Zhu Yu Tang. This patient had already suffered from headaches for 6-7 years, with the Tai yang exterior syndrome still present, currently turning into a Tai yang Tai yin concurrent syndrome. The dizziness due to the Tai Yang Tai yin syndrome fit the Ling Gui Zhu Gan Tang. Ban Xia is often added where the internal rheum in the upper is either severe or chronic especially in cases of heaviness of the head and distention of the eyes.