Combining Internal and External Treatment to Relieve Vertigo Caused by Cerebral Thrombosis: A Case Report

Doctor zhou December 26, 2022

The patient is my second aunt. In this wave she developed severe vertigo: whether sitting, lying or walking, she felt the world spinning, with nausea, headache and no appetite. She was hospitalized for several days at the local People Hospital without relief, and its doctors asked her to transfer to a higher-level hospital. But our provincial capital, Wuhan, had also become very hard to reach because of the epidemic.

On December 17, 2022, having learned of the situation, I contacted her and told the elderly woman to first soak her feet in ginger-scallion water, while asking family to frequently blow warm air from a hairdryer over the back of her head and cervical spine. The vertebral artery lies there; heat therapy over this area activates blood and resolves stasis, improving cerebral circulation. After this, her symptoms eased somewhat, but not markedly. She said it was hard to sweat.

On December 18, 2022, I sent a prescription to her grandson and asked him to fill 5 doses of herbs to relieve her symptoms. The prescription: Gegen (Pueraria) 30 g, Mahuang (Ephedra) 10 g, Guizhi (Cinnamon twig) 10 g, Chishao (Red peony) 10 g, Zhi Gancao (honey-fried licorice) 10 g, Shengjiang (fresh ginger) 15 g, Dazao (jujube) 12 pieces.

After taking 4 doses, her symptoms clearly lessened; she could get out of bed to go outside in the sun and eat a little. Every day she sat in the sun in front of her old country home, her back sweating faintly, though not profusely.

The elder reported her legs were still very weak. So I adjusted the prescription on the prior basis as follows: Gegen 30 g, Mahuang 10 g, Guizhi 20 g, Rougui (cinnamon bark) 10 g, Chishao 10 g, Zhi Gancao 10 g, Dilong (earthworm) 10 g, Xuduan (Dipsacus) 15 g, Duzhong (Eucommia) 15 g, Huainiuxi (Achyranthes) 15 g, Dizhechong (Eupolyphaga) 10 g, Dazao 12 pieces, Shengjiang 15 g.

This adjustment mainly added herbs that activate blood and resolve stasis, supplement the kidney and strengthen bone, and also lower blood pressure. But because her household affairs were chaotic, family was slow to buy the medicine. The epidemic was severe back home, and the last two days medication had been delayed; the elderly woman, frugal, was unwilling to keep taking medicine once the dizziness eased. I could only repeatedly urge my second uncle to buy the medicine and continue treatment, while telling my aunt to cut down on household salt.

My maternal grandmother had a very heavy palate; outsiders often found her cooking too salty to swallow. This habit influenced my mother and her three sisters: three of the four have already had a stroke, and only the youngest aunt has not. Over the years I have clashed repeatedly with my family over eating; I even wrote an article called "The War on the Dining Table" about exactly this. But no matter how earnestly I plead, I ultimately cannot change the eating habits of the older generation.

This diet is genuinely harmful. In my hometown there has long been a taste for cured fish and cured pork; as economic conditions have improved, the amount made each year is far greater than before. Hubeinese always say cured fish and meat taste better than fresh. Little do they realize that this custom has led to an especially high death rate from stroke among us country folk; we can only hope the next generation will change the diet.

Last night I asked my junior fellow apprentice, who works at the hometown hospital. He told me that the local TCM hospital and People Hospital have reached the point where beds are impossible to find; there are many patients with white lung and with cardiovascular/cerebrovascular stroke, and a death peak is feared over the next month or two. Though all this is strongly tied to the epidemic, had the diet of our hometown folks been better, cardiovascular disease would probably not be so rampant, and they would not have fallen so ill in this wave.

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