Dilong San for Wind-Phlegm Headache (Vascular Headache)

"Dilong San" comes from the Shengji Zonglu. Its composition is: Dilong (Earthworm, stir-fried), Banxia (Pinellia, pounded with ginger juice into a cake, baked dry, then ground into powder), and Fuling (Poria), each 15 g. Make the three above into a powder; each time take 5 fen to 1 qian (1.5-3 g), mixed with a decoction made from appropriate amounts of Shengjiang (Fresh Ginger) and Jingjie (Schizonepeta), twice daily. This formula expels phlegm and unblocks the collaterals; it treats headache caused by wind-phlegm.

A clarification is needed: the headache here attributed to wind-phlegm is in fact headache caused by cerebrovascular disease. Because headache from cerebrovascular lesions is usually accompanied by nausea and vomiting, the ancients believed it was caused by phlegm-saliva in the skull after a stroke. In reality, diseases diagnosed by modern neurology as cerebral thrombosis, cerebral hemorrhage, and the sequelae of cerebral hemorrhage can all cause headache with nausea and vomiting; in addition, primary or secondary intracranial tumors can also cause such symptoms, and all can be treated with this formula. This nausea and vomiting is not caused by phlegm-saliva but by compression of nerves; we must understand this disease using the pathological knowledge of modern medicine.

Dilong San is formulated precisely for these symptoms. The Dilong (earthworm) in the formula activates blood and resolves stasis, promotes urination, and also lowers blood pressure and has antitumor effects. Patients with intracranial tumors and cerebrovascular disease both require prolonged thrombolytic treatment; Dilong is a thrombolytic in Chinese medicine, and since cerebrovascular patients usually also have hypertension, using Dilong both dissolves clots and lowers blood pressure. At the same time, Dilong's diuretic action helps reduce intracranial edema; thus earthworm has, from ancient to modern times, been a common herb for cerebrovascular disease.

Both Banxia and Shengjiang in the formula have a strong antiemetic action and can relieve the nausea and vomiting of vascular headache patients; both also have diuretic effects. Fuling's main action is to fortify the spleen and promote urination, so it too is a diuretic. Jingjie induces sweating to release the exterior and relieves pain; it promotes the outward discharge of body fluids through the skin and relieves vascular headache. Combined, these herbs achieve thrombolysis, diuresis, blood-pressure reduction, detumescence, antiemesis, and analgesia, so the composition of this formula is also scientific from a modern medical standpoint.

Note, however, that raw Banxia, if improperly processed and put directly into a powder, is highly toxic: 0.1 g of raw Banxia can cause a fatal medical accident. Therefore, ordinary patients using this formula should best use the pharmacy's properly processed Jiang Banxia (ginger Pinellia), Fa Banxia, or Zhi Banxia, and should not use raw Banxia or Qing Banxia. Alternatively, one may replace Banxia with herbs of similar effect such as fresh Zhuli (bamboo juice), Zhuru (bamboo shavings), or Tianzhuhuang (bamboo sap) to ensure safe medication.