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In Chinese medicine, migraine headaches are referred to as pain tou tong (side head pain). However, they are also referred to as pian tou feng (side head wind). This last term suggests that all migraines are associated with an element of wind. That wind may be either externally contracted or internally engendered. Many Chinese doctors believe that all migraines involve externally contracted wind evils which have hidden deeply or lodged in the channels and network vessels of the head. Signs and symptoms of wind in the case of migraines include paroxysmal attacks which affect the uppermost part of the body, numbness and tingling, and dizziness and vertigo. Because the pain is very intense and commonly localized in one or two places, there is also blood stasis in the network vessel. This is based on Ye Tian-shi’s famous statement that new diseases are in the channels, but old or enduring diseases enter the network vessels. Because there is static blood in the network vessels, the disease is recalcitrant to treatment and requires special medicinals which free the flow of the network vessels.
Although 25% of the population suffers from a migraine headache at some point in their life, most patients with recurrent migraines are females, and, typically, migraines in females occur in relationship to their menstrual cycle, coming either before, during, or soon after menstruation. This means that female migraines are commonly associated with blood vacuity failing to nourish the liver properly. During the premenstruum, blood is sent down to the uterus. If the woman has a relative insufficiency of blood, this may leave the liver malnourished. Therefore, the liver qi fails to do its duty of governing coursing and discharge. Instead, the liver becomes depressed and the qi becomes stagnant. This may give rise to depressive heat which then engenders ascendant yang hyperactivity. It may also give rise to internal stirring of wind. Further, it may cause spleen vacuity which results in a defensive qi vacuity and easy entrance and attack by external wind evils. Likewise, loss of blood during menstruation and an emptiness of the sea of blood post-menstrually may also give rise to any of the above scenarios. If spleen vacuity engenders dampness and dampness congeals into phlegm, phlegm turbidity may be drafted upward with counterflowing qi and yang. In somewhat older women, yin vacuity may fail to control yang. Thus leading to ascendant liver yang hyperactivity and the internal engenderment of wind.
Celestial Mansion is the Blue Poppy version of Sou Feng Huo Xue Tang (Track Down Wind & Quicken the Blood Decoction) created by Yuan Ming and Qiu Hao of the Shengzhou Municipal Chinese Medical Hospital in Zhejiang province. Within this formula, Bai Zhi, Man Jing Zi, and Bai Ji Li scatter wind, free the flow of the network vessels, and stop pain. Jiang Can, Quan Xie, and Wu Gong track down wind, free the flow of the network vessels, and stop pain. Chuan Xiong moves upward to the head and eyes and downward to the sea of blood. It moves the qi within the blood and dispels wind within the blood. It quickens the blood and transforms stasis as well as moves the qi and stops pain. Dang Gui, Dan Shen, and Bai Shao both nourish and quicken the blood, relax cramping or spasm, and stop pain. therefore, when all these medicinals are used together, they track down wind and free the flow of the network vessels, quicken the blood, dispel stasis, and stop pain.
In a study of 42 patients 15-56 years old, 28 of whom were female and who had suffered from migraines for from 1-30 years, this formula achieved a 92.9% total amelioration rate. Eleven out of 42 cases were cured, 18 got a marked effect, 10 got some effect, and only three failed to experience any improvement. This was compared to a comparison group of 42 similar patients treated with Western medicine which only achieved a 73.8% total amelioration rate and only half the cure rate.(1)
If there is simultaneous phlegm turbidity, this formula can be combined with either Er Chen Wan (Two Aged [Ingredients] Pills) or Ban Xia Hou Po Wan (Pinellia & Magnolia Pills). If there is marked ascendant liver yang hyperactivity, it may be combined with Tian Ma Gou Teng Yin Wan (Gastrodia & Uncaria Beverage Pills). If there is simultaneous yin vacuity, it may be combined with Qi Ju Di Huang Wan (Lycium & Chrysanthemum Rehmannia Pills). If there is simultaneous (qi and) blood vacuity, it may be combined with Ba Zhen Wan (Eight Pearls Pills). If there is a liver-spleen disharmony with blood vacuity, it may be combined with Xiao Yao Wan (Rambling Pills). If liver depression has transformed heat, it may be combined with Dan Zhi Xiao Yao Wan (Moutan & Gardenia Rambling Pills), and, if blood stasis is really severe, it can be combined with Tong Qiao Huo Xue Wan (Free the Flow of the Orifices & Quicken the Blood Pills).
When migraines occur from premenstrually or during the menstruation itself, this formula should only be taken from ovulation through menstruation. During the proliferative and follicular stages of the menstrual cycle, the patient should be treated with other formulas that address her root disease mechanisms, such as blood and/or yin vacuity, liver depression, and spleen vacuity.
1. Yuan Ming & Qiu Hao, "A Clinical Survey of the Treatment of 42 Cases of Migraine Headache with Self-composed Sou Feng Huo Xue Tang (Track Down Wind & Quicken the Blood Decoction)," An Hui Zhong Yi Lin Chuang Za Zhi (Anhui Journal of Clinical Chinese Medicine), #3, 2003, p. 191
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