Chapter 1:
Chapter I Painful Diseases
1.1 Headache
Headache is a subjective symptom that occurs for a variety of reasons and accompanies many acute and chronic diseases. The type of headache discussed in this chapter refers to the "headache" as the main symptom present, regardless of etiology or other disorders. For example, a headache may be seen with infectious febrile diseases, hypertension, intracranial disease, traumatic injury, psychoneurosis, migraine, and others.
Point
Fengchi (GB 20)
Location
Fengchi (GB 20) is located on the nape of the neck, below the occipital bone, on the level of Fengfu (DU 16), and in the depression between the heads of the sternocloidomastoid and trapezius muscles.
Methods
1. Acupressure is used. With the patient in a seated position, use the thumb and middle finger of the right hand to squeeze Fengchi (GB 20) on both sides using pressure and/or rolling technique. Begin in this manner on both sides first mildly, then gradually increasing in intensity. For one course of treatment, this procedure should be done for 10~15 minutes and repeated daily for seven days.
2. Electro-acupuncture is used. With the patient in a seated position, insert a 1.5cun needle into bilateral Fengchi (GB 20). Angle the needles toward the opposite ear and insert to a depth of 1.2~1.3cun. Manipulate each needle until the patient can feel the Qi sensation. Apply the electro-stimulation machine using continuous frequency waveform for 20~30 minutes. Repeat daily for ten days to complete one course of treatment.
3. Point injection is used. A 5ml syringe containing 2ml of vitamin B1, 2ml of 0.5% lidocaine and 1ml of vitamin B12 is needed. With the patient is in a seated position, locate and sterilize bilateral Fengchi (GB 20). Upon insertion, angle each needle towards the opposite ear and insert to a depth of 2.5cm. Once the depth is reached, aspirate the handle of the syringe back to be sure that no blood comes out and then inject the fluid while simultaneously withdrawing the needle. Usually one injection on each side is enough. If results are insufficient, repeat after 2~3 days.
Results
1. Method No.1: 56 cases with headaches ranging from one to more than five years in duration were treated with the acupressure method. Of these, 43 cases had functional headaches, 10 cases had hypertensive headaches, and three cases had headaches associated with dysmenorrheal: 36 cases completely resolved; 19 cases improved; and one case had no effect. All successful cases required no more than two courses of treatment.
2. Method No.2: 260 cases presented with headache from sinusitis and as a result of side-effects from medications, and were treated with one course of electro-acupuncture: 258 cases completely resolved; and two cases showed no improvement.
3. Method No.3: 50 cases presented with severe chronic headaches from head injuries, trigeminal neuralgia, or an intracranial space occupying lesion. Within four courses of point-injection treatment: 28 cases had completely resolved; 14 cases had improved slightly; and one case had no change.
Cases
1. Lai xx, male, 9-year old student: Presented with severe headache for the past six months. Clinical examination and cranial CT scan were normal. His headache improved after the first acupressure session of treatment and disappeared after the fifth session.
2. Ye xx, female, 56-year old officer: Presented with severe temporal headache of ten years duration, which increased on exposure to cold and with overwork. After three sessions of electro-acupuncture, the pain was relieved completely.
3. Tan xx, male, 41-year old teacher: Presented with persistent headache since being involved in a traffic accident six months prior. After the accident, he was hospitalized and comatose for five days until he awoke with a severe headache and nausea and vomiting. While other symptoms have improved, his headache remained. The patient was treated with the point-injection protocol every other day. After three treatments, his headache pain had vanished.
Discussion
1. The three methods above are to be used in different presentations of headache. The acupressure is best suited for mild cases, the electro-acupuncture for moderate headaches, and the point injection for severe headaches.
2. Fengchi (GB 20) is very rich in nerve supply, and is located close to important muscles of the neck, head, and primary intracranial vessels and nerves. All the methods discussed improve Qi and blood flow around Fengchi (GB 20), and thus are effective in alleviating headache.