WESTERN MEDICAL KNOWLEDGE: Hypertension usually means the primary hypertension (or benign essential hypertension). It is a disorder of unknown origin characterized by an elevated diastolic pressure associated with generalized arteriolar vasoconstriction. The diagnosis of hypertension is likely if the diastolic pressure rises even occasionally to > 95 mm Hg. The diagnosis becomes increasingly probable the more often this value is exceeded, and when emotional, physiologic, arterios clerotic factors can be excluded. Diagnosis of primary hypertension rests on the repeated finding of elevated diastolic pressure when other causes have been excluded. In the treatment, it seems that no known therapy can correct the abnormalities and reverse the course of the disease, but reduction of BP level does appear to be beneficial.
SYMPTOMS AND SIGNS: Primary hypertension may be present for many years without other symptoms or signs. In the majority, increased BP first appears during the early 30's. Patients may complain of fatigue, nervousness, dizziness, palpitation, insomnia, weakness, and headaches. However, such complaints should not be attributed routinely to hypertension. In clinical practice, headaches and dizziness are two of the major symptoms.
ETIOLOGY AND PATHOLOGY: According to the western medical point of view, heredity has been implicated as a predisposing factor, as well as ingestion of large amounts of sodium chloride. Chinese medicine consider these symptoms to be caused by flaming Qi attacks on the head by excessive or deficient liver Yang; or lack of nourishment due to Qi and blood deficiency, or kidney Yin and Yang deficiency; or by the obstruction of phlegm and dampness.
1. Excessive Liver Fire Type:
Indications: Dizziness, headache, tinnitus, flushed face, nausea, restlessness, insomnia, nightmare, easily angered, bitter taste in mouth, constipation, yellow or red urine, red tongue body, yellow tongue coating, wiry and rapid pulse.
Treatment & Formulas: Clear the excess liver fire. Long Dan Xie Gan Tang (Gentiana Combination, Item no. 2267)
- Chai Hu Jia Ling Gu Mu Li Tang (Bupleurum and Dragon Bone Combination, Item No. 2154): Both are popularly used formulas for hypertension due to the liver fire type.
2. Deficient Liver Fire Type:
Indications: Dizziness, headache, sore and weakness of lumbar region, tinnitus, forgetfulness, hot sensation in the four palms, restlessness, insomnia, palpitation, night sweating, red tongue, thin coating, wiry, thready and rapid pulse.
Treatment & Formulas: Nourish the liver and kidney Yin to sedate the deficient fire.
3. Deficiency of Kidney Yin and Yang Type:
Indications: Dizziness, headache, tinnitus, palpitation, shortness of breath, sore and weak sensation at lumbar region, insomnia, dream sleep, twitching of eyelid or muscles, pale or red tongue, white coating, wiry and thready pulse.
Treatment & Formulas: Tonify kidney Yin and Yang.
- Ba Wei Di Huang Wan (Rehmannia Eight Formula, Item No. 2011)
4. Qi and Blood Deficiency Type:
Indications: Dizziness, worse after working or activities, pale face, lips and fingernails, palpitations, insomnia, fatigue, lazy speech, anorexia, pale tongue, thready and weak pulse.
Treatment & Formulas: Tonify both Qi and blood.
5. Obstructions of Phlegm and Dampness:
Indications: Headache, dizziness, heavy and tight feeling of head, oppression and full sensation at chest, palpitation, poor appetite, vomiting foamy phlegm, white greasy tongue coating, slippery pulse.
Treatment & Formulas: Resolve phlegm and dampness, harmonize the relationship of spleen and liver.
- Ban Xia Bai Zhu Tian Ma Tang (Pinellia and Gastrodia Combination, Item No. 2066)