The term xuan yun is used in Traditional Chinese Medicine to describe both dizziness and vertigo and is characterised by symptoms ranging from mild light-headedness or giddiness, to severe loss of balance and equilibrium disturbance.
The mild end of range, termed dizziness, may only occur on moving and last a few seconds. Occasionally, fainting may occur. It is frequently accompanied by blurring vision or spots in the visual field.
Vertigo is generally more severe, and is characterised by a sudden sensation of spinning, or the surroundings rotating. It may be described as ‘head spinning’, ‘the room spinning’, ‘bed spins’ or ‘everything rocking and swaying’. Vertigo may or may not be precipitated by movement of the head, and may last for minutes or hours. Patients occasionally awake from sleep with vertigo. During episodes they usually become frightened and tend to remain immobile. Nausea, vomiting and tinnitus are often associated with vertigo.
In Traditional Chinese Medicine, dizziness and vertigo are primarily due to either excess or deficiency affecting the head. In excess patterns, there is too much of some pathological entity in the head which hinders the normal flow of yin, yang, qi and blood. In the deficient patterns, there is too little of some physiological substance (Blood, qi, yang, jing) getting to the head.
Aetiology
Liver Qi Stagnation, Liver Qi Stagnation with Stagnant Heat, Liver Fire and Liver Yin Deficiency with Yang Rising:
Frustration, anger, resentment, prolonged emotional turmoil, repressed emotions and stress disrupts the circulation of Liver qi. When qi stagnates for any length of time, the resulting pressure can generate Heat. Depending on the intensity of the condition, this can cause stagnant Heat, and the more server Fire or the eventual generation of internal Wind. Qi stagnation can give rise to Phlegm by damaging the Spleen and retarding the movement of fluids.
Qi stagnation, stagnant Heat and Fire are excess patterns. Once there is Heat, it can deplete and scorch the yin, giving rise to the more chronic yin deficiency with yang rising, or Liver Wind. The Wind that gives rise to dizziness is most frequently associated with Liver yin deficiency, although dizziness may be a symptom of all the patterns that can be caused by internal Wind. The dizziness associated with Liver qi stagnation is generally quite mild (may be described as ‘light-headedness’) and due to poor distribution of qi and Blood. Dizziness severe enough to cause loss of balance or collapse is associated with rising Liver yang or Wind.
Phlegm Damp:
Phlegm Damp is generated by overindulgence in Phlegm or Damp producing foods and are associated with eating habits that weaken Spleen qi. Repeated courses of antibiotics can also damage Spleen qi, allowing the generation and accumulation of Dampness. Foods that can weaken the Spleen if consumed in excess include dairy products. fatty, sweet or raw foods, and alcohol. Once the Spleen is weak, inefficient digestion allows accumulation of Dampness, which over time congeals into Phlegm. In the presence of Heat, Damp may be condensed to from Phlegm in a shorter time.
Poor fluid metabolism (due to Spleen, Lung or Kidney dysfunction) may cause stagnation, accumulation and thickening of physiological fluids into Phlegm. In addition, prolonged Liver qi stagnation can contribute, by weakening the Spleen and by retarding the movement of fluids, which gradually condense into Phlegm. Phlegm can fill the head, obstructing the ‘clear yang’ of the senses, and also obstruct the passage of qi and Blood to the head, causing relatively server dizziness.
Stagnant Blood:
Stagnant Blood type dizziness usually follows an injury to the head. It can also follow other long term pathologies, particularly stagnant qi, yin deficiency or Phlegm, all of which obstruct the circulation of qi and Blood.
Stagnant Blood type dizziness also appears to occur post-partum if the birth products and lochia are not completely expelled. If the complete downward discharge of chong mai is obstructed by stagnant Blood, chong mai qi will accumulate and rebel upwards to the head.
Qi and Blood Deficiency
Overwork, excessive worry or mental activity, irregular dietary habits, excessive consumption of cold raw foods or prolonged illness can weaken Spleen qi.
The Spleen (and Lungs) are the source of the body’s qi and Blood, so weakness of these organs will inevitably lead to a decrease in production of qi and Blood. Other causes are acute or chronic haemorrhage, extended breast feeding and malnutrition (seen for example in vegetarians who consume too little protein). Qi and Blood are so closely related that deficiency of one often leads to deficiency of the other.
Kidney Deficiency:
Kidney deficiency can be either jing, yang or yin deficiency. Kidney deficiency may be inherited or may develop as a result of age, chronic illness or excessive sexual activity. Kidney yang or qi is particularly affected by prolonged exposure to cold conditions or excessive lifting or standing (particularly if this occurs in a cold environment). In younger people, Kidney qi may be weakened while Kidney yang remains intact, in which case the cold symptoms are not seen.
Kidney yin is damaged through overwork (especially while under stress), insufficient sleep, febrile disease, insufficient fluid replacement and by the use of some prescription and recreational drugs. Kidney yin may also be damaged by pregnancy or haemorrhage following childbirth.
Treatment
After a diagnosis from a qualified practitioner has been given, acupuncture is the treatment of choice and herbal medicines are recommended to support correcting any systemic imbalances that may be present.