A Splitting Headache and a Spinning Room — Two Doses and It Was Gone

💬 Note from Doctor Luo: Yesterday we saw Doctor Li Dongyuan stop uterine bleeding with a single dose — the touch of a master. Today’s case is even more striking: dizziness and headache. The symptoms are complex and frightening, yet Doctor Li’s two doses cured it. After you hear this one, you’ll understand why he’s one of the Four Great Masters.

The story starts with the patient’s underlying constitution.

The patient: a daughter-in-law with a lifelong weak spleen

The patient was the wife of Fan Tianlai, and she fell ill in mid-October.

💬 Note from Doctor Luo: This woman had always had spleen-stomach trouble. What did that look like? Frequent irritability, chest discomfort, constipation. These are classic signs of spleen-stomach weakness. The spleen and stomach are the pivot of the middle burner — the hub where qi rises and falls. Spleen qi rises on the left, stomach qi descends on the right, like a single axis. When spleen qi rises, liver qi follows it up; when stomach qi descends, gallbladder qi, lung qi and heart fire all move down — this is “water and fire in harmony,” the healthy state. When the spleen and stomach weaken, qi gets stuck in the middle, rising and falling go wrong, and the person feels restless, congested and constipated.

How the illness began: cold, then a bad doctor

That October, the weather had turned cold. The woman went out one night and came home late, chilled by the cold, feeling oppressed and deeply uncomfortable.

💬 Note from Doctor Luo: This was “fire unable to rise” — not a real excess of fire, but yang qi unable to unfold because the movement of qi was blocked. If a doctor misreads this mechanism, everything after goes wrong.

And that’s exactly what happened. The doctor saw irritability and heat and concluded: fire! He prescribed shu feng wan (wind-dispersing pills) — scattering wind-cold, clearing internal heat, and purging downward all at once.

After taking them, her bowels moved — but the original symptoms didn’t improve at all. The doctor assumed the dose was too weak and doubled it, seven or eight more pills. Now the bowel movements increased by two or three more a day, the original illness didn’t improve, and new problems piled on top!

How sick was she? Vomiting, vertigo, and a splitting headache

After the doubled dose, everything erupted:

• Vomiting and regurgitation, nothing staying down — vomiting all night
• Thick, sticky phlegm pouring up endlessly
• Dry stinging eyes, the world spinning — like the sky and earth were revolving
• Nausea, oppression, shortness of breath, wheezing
• Too weak to speak a single word
• The mind in chaos, restless and reeling
• A headache so severe it felt like the skull was splitting
• The body heavy as a mountain — no energy to move
• Four limbs ice-cold, unable to lie still

💬 Note from Doctor Luo: Terrifying symptoms — splitting headache, unable to open the eyes without the room spinning, vomiting sticky phlegm. Today such a patient would be diagnosed with Meniere’s disease, vertigo, cervical spine problems… and it could all be this same path. What was really going on? Doctor Li’s disciple Luo Tianyi (who compiled the book) recorded his teacher’s judgment.

The diagnosis: a spleen wounded by purgatives, phlegm surging upward

Doctor Li’s analysis: this patient’s spleen-stomach qi had been weak from the start — the earlier irritability, chest tightness and constipation were already signs of spleen deficiency generating phlegm. Then the external cold struck and weakened the vital qi further; then the two rounds of purging finished off the spleen and stomach.

The disease was called tan jue tou tong — phlegm-revulsion headache.

💬 Note from Doctor Luo: What is a phlegm headache? In TCM: “The spleen is the source of phlegm; the lungs are the vessel that stores it.” The root of phlegm is the spleen. The spleen manages water (earth controls water) — when the spleen weakens, it can’t govern water and dampness; fluids spread out of control and slowly congeal into phlegm. With the spleen weak, the clear qi can’t rise and the turbid qi can’t descend — the turbid yin climbs upward and clouds the “clear orifices” of the head. Dizziness, headache — turbid yin up top is the single cause. The sticky phlegm is stomach qi reversing upward, shoving the turbidity up with it.

The prescription: Banxia Baizhu Tianma Tang — the ancestral formula for vertigo

Doctor Li prescribed Banxia Baizhu Tianma Tang (Pinellia, Atractylodes and Gastrodia Decoction) — the most classic formula in TCM history for dizziness and headache. Hospitals still use it today for vertigo, cervical-spine dizziness and Meniere’s disease, with a large body of research papers confirming its effectiveness.

Preparation: grind all herbs to a fine powder; take 15 g per dose, simmer in two large cups of water down to one cup, strain, and drink while hot.

💬 Note from Doctor Luo: This formula deserves a close look.

First, pinellia leads the charge. Doctor Li said this disease “cannot be cured without pinellia” — pinellia resolves phlegm, directs qi downward and stops vomiting; it drags the surging turbid qi back down.

Second, gastrodia settles the wind. The black vision and spinning head are “deficiency wind stirring within,” and Doctor Li said “cannot be removed without gastrodia.” Gastrodia is also called the wind-settling herb — the legend says when the wind blows and every other plant bends over, only the gastrodia seedling stands straight. It extinguishes wind, settles spasms and calms liver yang. Today it’s classified as food-grade medicinal; elderly people take gastrodia for dizziness for exactly this reason.

Third, the doses are astonishingly small. Astragalus 1.5 g, ginseng 1.5 g — one qian is 3 g; half a qian is 1.5 g! Why so frugal? Because in Doctor Li’s era of war, ordinary people were poor and couldn’t afford medicine, so physicians learned to grind herbs into powder and cure with the smallest possible amounts. Today, with better conditions, we hand out big sacks of herbs — and have lost this careful economy.

Fourth: tonify the spleen + dry dampness + direct qi downward, all at once. Astragalus and ginseng rebuild the vital qi (no need to drain deficiency fire — when qi is sufficient, the fire fades by itself); bai zhu, cang zhu, fu ling and ze xie dry dampness (the spleen hates dampness — dry the water, and the earth of the spleen becomes firm); pinellia and chen pi direct qi downward; shen qu and mai ya help digestion; gan jiang warms the middle; wine-prepared huang bai restrains a touch of winter dryness-fire. The whole formula is Er Chen Tang (Two-Cured Decoction) as the base (pinellia, fu ling, chen pi), upgraded with spleen-tonifying, damp-drying, wind-settling herbs — cutting off the entire chain from “spleen deficiency generating phlegm” to “turbid yin rising.”

The result: cured after the second dose

The powder was simmered and drunk. The second dose finished it — the illness was gone.

💬 Note from Doctor Luo: In classical usage, “again take” means the second time. Two doses for such a complicated illness. Doctor Li established a permanent rule for later generations: spleen deficiency → heavy damp-phlegm → clear qi fails to rise, turbid qi fails to descend → turbid yin on top → dizziness and headache — treat it with Banxia Baizhu Tianma Tang. Its modern applications are broad:

• Hypertension (the type with a thick greasy tongue coating, swollen tongue, phlegm, obesity, unstable or elevated diastolic pressure) — excellent blood-pressure-lowering results
• Meniere’s disease, cervical vertigo — the same logic
• Numerous research papers confirm it improves cerebral circulation and blood lipids

Most hospitals today use the simplified version from the Qing-dynasty Yixue Xinwu (Medicine’s Comprehension) — a few herbs fewer than Doctor Li’s original — but the ancestor is here: Doctor Li’s original formula is the more complete one.

Bonus: two herb details almost nobody remembers

💬 Note from Doctor Luo: Two preparation details in this formula are largely forgotten today, and worth reviving.

One is the malt powder (mai ya mian). Doctor Li’s writings often mention “mai nie mian” — malt flour. His teacher Zhang Yuansu (the Old Man of Jiegu) recorded the proper method: the malt should be pounded, fried yellow, and the flour taken as medicine — far more careful than just tossing fried malt into the pot as we do now. Raw and fried malt behave differently: raw malt sends qi upward (sprouts grow upward; it can lift yang), while fried malt sends qi downward (aids digestion) and can “widen the middle and assist stomach qi,” helping stomach qi descend.

The other is phellodendron (huang bai). Here it’s used at only ~0.6 g, and prepared with wine — to soften its cold nature. Why include it at all? Doctor Li calculated by the five movements and six qi system that this particular winter had “fire predominant,” making people prone to dryness — so he added a speck of wine-prepared huang bai to restrain it. In most ordinary years, you might not need it.

You see — in one formula, even how to fry the malt, how to prepare the huang bai, and why to include it at all, all carry meaning. That’s what makes a classic formula: layer upon layer of learning.

Bonus: how to recognize this body type

💬 Note from Doctor Luo: Finally, let’s learn to recognize the damp-phlegm constitution:

• Thick, greasy tongue coating, a swollen tongue, the head feeling foggy, wrapped in cotton
• Easy chest tightness, palpitations, bloating, nausea, vomiting
• Lower legs that pit when pressed (edema), cold limbs, a heavy body
• Scanty urination, loose stools or constipation, stools that stick to the toilet bowl
• Common among mental workers, overweight people, middle-aged and older women

Such people, when dizzy or headache-ridden, often leave the hospital with a Meniere’s, cervical-spine or hypertension diagnosis… but the ancients already mapped this out. The illnesses of modern people — the ancients already thought of them.

Case source: Secrets from the Orchid Chamber by Doctor Li Dongyuan (compiled by disciple Luo Tianyi); commentary based on public lectures by Doctor Luo Dalun (PhD in TCM diagnostics, Beijing University of Chinese Medicine).