A 73-year-old man has had recurrent distending headaches, vertigo, and tinnitus for half a year. He is irritable and sleeps poorly, but has no clear bitter taste or constipation. Tongue is red with scant coat. Pulse is wiry, thin, and slightly rapid. What is the most likely pattern?
Four training angles
Vertigo, Tinnitus, and Distending Headache: Pattern
Vertigo, Tinnitus, and Distending Headache: Treatment Principle
Vertigo, Tinnitus, and Distending Headache: Formula
Vertigo, Tinnitus, and Distending Headache: Points
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Vertigo, Tinnitus, and Distending Headache: Pattern
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Vertigo, Tinnitus, and Distending Headache: Treatment Principle
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Vertigo, Tinnitus, and Distending Headache: Formula
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Vertigo, Tinnitus, and Distending Headache: Points
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Case-to-knowledge links
Scanty Coating
A scanty coating often suggests fluid or Yin deficiency and is an important clue to a deficiency-rooted pattern.
Wiry Pulse
A wiry pulse is commonly associated with Liver patterns, pain, and phlegm-fluid disorders. It feels taut and straight, like a tightened string.
Dizziness
Dizziness may come from upward disturbance or from lack of nourishment. It is often used in stems to test whether you can distinguish excess from deficiency.
Tinnitus
Tinnitus often relates to the Liver, Kidney, or upward disturbance, but it should not be reduced to Kidney deficiency alone.
Liver Yang Rising
Liver Yang Rising is usually a mixed root-branch pattern: the root is Yin deficiency, while the branch is upward disturbance of Yang. In exam stems it often appears with headache, dizziness, tinnitus, irritability, a red tongue, scanty coating, and a wiry pulse.