Yue Bi Jia Zhu Xia Geng Tang Pattern to treat Migraines

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

 

Ms. Liu, 36 years old

1st consultation on March 9th, 1965

The patient suffered from recurring headaches for 5 years, more prevalent in the afternoon, accompanied by fatigue, irregular and insufficient sleep. She underwent many examinations which did not yield a clear diagnosis, mostly attributed to neurogenic headaches and was treated with sedatives and pain killers which partially alleviated the pain but did not resolve it. During the month prior to consultation she underwent an X-ray exam due to a severe frontal headache, which was diagnosed as sinusitis. She took antibiotics and TCM formulas with no obvious effect.

 

Recent symptoms: Headaches, more accented in the forehead, accompanied by distending pain in both eyes, neck tension, head heaviness, upper back soreness, dry throat, easily vexed, no nasal congestion or discharge, white tongue which was greasy at the root, deep, thready and wiry pulse which was floating at the left cun position.

 

Symptoms analysis:

1. Tai yang syndrome: Headache, neck tension, upper back soreness, floating pulse

2. Tai yang Tai yin concurrent syndrome: Heaviness of the head, distending pain in the eyes

3. Tai yin syndrome: greasy tongue coating, deep pulse

4. Yang Ming syndrome: dry throat, easily vexed

 
 

Six syndrome: Tai yang Yang ming Tai yin concurrent syndrome

Formula pattern: Yue Bi Jia Zhu Ban Xia Jie Geng Tang pattern

Ma Huang 12g Sheng Jiang 10g Zhi Gan Cao 6g
Da Zao 4 pcs Sheng Shi Gao 45g Cang Zhu 15g
Ban Xia 12g Jie Geng 10g

 

Result: After taking 3 packs of the formula, the headache improved and after 6 packs it subsided. Since her neck still felt tight, she was prescribed 6 further packs, after which her syndrome resolved entirely.

 

Note: This patient presented with a chronic condition where she suffered from chronic head for over 5 years; however, her symptoms still reflected an external syndrome combined with internal rheums transforming into heat, fitting a Tai yang Tai Yin Yang ming concurrent syndrome. The formula Yue Bi Tang can resolve the pathogene on the exterior layer while clearing internal yang ming heat. When it is combined with Cang Zhu, Ban Xia and Jie Geng it can also treat the internal rheums stagnation causing the symptoms. As we see the effect was prescribe correctly as the results were very effective. Ban Xia targets the internal rheum causing the symptoms of the distending pain in the eyes, Jie Geng targets the dry throat while expelling phlegm and Cang Zhu strengthen the internal to further expel dampness.

 

This case was treated with a combination of Yue Bi Jia Zhu Tang plus Yue Bi Jia Ban Xia. Yue Bi Jia Zhu Tang was recorded in the《Jin Gui Yao Lue· On Water Qi Disorders》line 5:

 

“[In case of] internal rheum, if the whole body, face and eyes are yellow and swollen, the pulse is deep and there is inhibited urination, this is pathogenic water. If urination is disinhibited, the body fluids are damaged causing thirst, Yue Bi Jia Zhu Tang governs.”

《金匮要略·水气病》第5条：里水者，一身面目黄肿，其脉沉，小便不利，故令病水。假令小便自利，此亡津液，故令渴也，越婢加术汤主之。

 

Yue Bi Jia Ban Xia Tang pattern was recorded in the 《Jin Gui Yao Lue· On Lung Consumption, Welling Lung Abscesses, Cough and Up Surging Qi Disorders》line 13:

 

“If there is cough and upsurge of qi, it is due to emphysema, the patient will experience panting with eyes which feel like they are protruding outward, the pulse is floating and large, Yue Bi Jia Ban Xia Tang governs. ”

《金匮要略·肺痿肺痈咳嗽上气病》第13条：咳而上气，此为肺胀，其人喘，目如脱状，脉浮大者，越婢加半夏汤主之。