Trigeminal neuralgia according to Chinese Medicine

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Trigeminal neuralgia factsheet

In Chinese Medicine, trigeminal neuralgia can be associated with twelve so-called "patterns of disharmony". Chinese Medicine sees the body as a system, not a sum of isolated parts. A "pattern" is when the system's harmony is disrupted. It is not equivalent to the Western concept of "disease", as a matter of fact here trigeminal neuralgia can be caused by twelve different patterns.

To understand whether someone's trigeminal neuralgia might be caused by a given pattern, one needs to look for signs and symptoms associated with the pattern beyond what one might typically experience from trigeminal neuralgia alone. For instance when trigeminal neuralgia is caused by the pattern Heat and Blood Stagnation in the Lower Burner, patients also experience symptoms such as lower abdominal pain, night fever, delirious speech and irritability. Similarly, patients with Heat and Blood Stagnation in the Lower Burner typically exhibit choppy (Se) or full (Shi) pulses.

We've listed below a description of the twelve patterns associated with trigeminal neuralgia so that you can start to get an understanding of the various possibilities according to Chinese Medicine.

Once identified, patterns are often treated using herbal formulas. Drinking herbal infusions is the most common remedy in Chinese Medicine, together with acupuncture. Here we detail below eight formulas that can help treat the various patterns associated with trigeminal neuralgia, depending on which pattern fits your profile.

The twelve "patterns of disharmony" associated with trigeminal neuralgia

The Triple Burner is a so-called "Fu" Organ. Learn more about the Triple Burner in Chinese Medicine

Heat and Blood Stagnation in the Lower Burner

Pulse type(s): Choppy (Se), Full (Shi)

Recommended herbal formula: Tao He Cheng Qi Tang

Symptoms: Thirst Amenorrhea Night fever Irritability Dysmenorrhea Restlnessness Delirious speech Lower abdominal pain

Trigeminal neuralgia might be due to Heat and Blood Stagnation in the Lower Burner if the condition is paired with typical pattern symptoms such as lower abdominal pain, night fever, delirious speech and irritability. Similarly, patients with Heat and Blood Stagnation in the Lower Burner typically exhibit choppy (Se) or full (Shi) pulses.

Read more about Heat and Blood Stagnation in the Lower Burner here

Crow-Dipper Rhizomes (Ban Xia) is the key herb for Er Chen Tang, a formula used for Phlegm

Phlegm

Pulse type(s): Slippery (Hua), Wiry (Xian)

Tongue coating: Sticky coating, Thick coating

Tongue shape: Swollen

Recommended herbal formulas: Er Chen Tang, Liu Jun Zi Tang, Ban Xia Bai Zhu Tian Ma Tang, Wen Dan Tang, Hao Qin Qing Dan Tang, Xing Su San, Wu Ling San

Symptoms: Lumps Nausea Nodules Dizziness Chest pressure Feeling of heaviness Numbness in the limbs

Phlegm has a great importance in Chinese Medicine as it is both a condition in and of itself as well as a cause for other diseases.

The main cause for the formation of Phlegm is Spleen Deficiency since the Spleen rules the transformation and transportation of Body Fluids. If this function is impaired, Body Fluids accumulates and change into Phlegm. 

The Lungs and Kidneys may also be involved since they each play a role in handling body Fluids: the Lungs disperse and descend Body Fluids while the Kidneys transform and excrete them. Again, if they fail to perform those roles, Body Fluids will accumulate and become Phlegm.

That being said, the Spleen malfunction is the fundamental reason behind the formation of Phlegm and, as such, treatments will focus on it first and foremost.

There are two broad types of Phlegm: so-called "Substantial Phlegm" and "Non-Substantial Phlegm". Simply put, Substantial Phlegm can be seen, such as sputum in the Lungs and throat. Non-Substantial Phlegm is more hidden and will manifest itself into, for instance, kidney stones, gallstones or arthritic bone deformities.

Phlegm can further be categorized according to its nature: there is Damp-Phlegm, Phlegm-Heat, Cold-Phlegm, etc. 

Lastly, there is a type of Phlegm called "Phlegm-Fluids". It is very similar to Dampness and is very watery and thin. It can be heard splashing in the body, found usually in the Stomach, Intestines, hypochondrium, limbs or above the diaphragm.

Read more about Phlegm here

The Spleen is a so-called "Zang" Organ. Learn more about the Spleen in Chinese Medicine

Spleen Deficiency with Dampness

Trigeminal neuralgia might be due to Spleen Deficiency with Dampness if the condition is paired with typical pattern symptoms such as edema, general sensation of heaviness, diarrhea and urinary difficulty.

Read more about Spleen Deficiency with Dampness here

The Triple Burner is a so-called "Fu" Organ. Learn more about the Triple Burner in Chinese Medicine

Phlegm in the Lower Burner

Trigeminal neuralgia might be due to Phlegm in the Lower Burner if the condition is paired with typical pattern symptoms such as throbbing pulsations just below the umbilicus, vomiting frothy saliva, vertigo and shortness of breath.

Read more about Phlegm in the Lower Burner here

Exterior Cold invading the Interior

Pulse type(s): Tight (Jin), Wiry (Xian)

Tongue coating: Thick white coating

Recommended herbal formula: Da Huang Fu Zi Tang

Symptoms: Chills Constipation Abdominal pain Low-grade fever Hypochondriac pain Cold hands and feet

Trigeminal neuralgia might be due to Exterior Cold invading the Interior if the condition is paired with typical pattern symptoms such as abdominal pain, constipation, hypochondriac pain and chills. Similarly, patients with Exterior Cold invading the Interior typically exhibit tight (Jin) or wiry (Xian) pulses as well as a tongue with thick white coating.

Read more about Exterior Cold invading the Interior here

The Stomach is a so-called "Fu" Organ. Learn more about the Stomach in Chinese Medicine

Stomach Fire or Stomach Heat

Pulse type(s): Rapid (Shu), Slippery (Hua), Full (Shi)

Tongue coating: Yellow coating

Tongue color: Red centre

Recommended herbal formulas: Qing Wei San, Yu Nu Jian

Symptoms: Thirst Dry mouth Toothache Headaches Dry stools Constipation Mouth ulcers Irritability Restlnessness Bleeding gums Epigastric pain Sour regurgitation

Stomach Fire indicates a true Excess of Heat in the Stomach, creating symptoms such as mouth ulcers, bad breath, intense thirst and bleeding of the gums. Body Fluids are burned off by the excessive Heat, which creates extreme thirst and constipation. Over time the Heat can cause obstruction to Stomach Qi, resulting in vomiting, acid reflux and nausea.

Stomach Fire can be the result of excessive intake of hot, spicy, greasy, sugary and deep fried foods. Other factors such as alcohol and tobacco use may also be the reason. Stomach Fire often derives from other patterns such as Stomach Qi Stagnation. Anger, frustration and resentment can cause such stagnation, which as a result leads to Stomach Fire. 

Read more about Stomach Fire or Stomach Heat here

The Spleen is a so-called "Zang" Organ. Learn more about the Spleen in Chinese Medicine

Spleen or Kidney Yang Deficiency

Pulse type(s): Deep (Chen), Fine (Xi)

Tongue color: Pale

Tongue shape: Tooth-marked, Swollen

Recommended herbal formula: Zhen Wu Tang

Symptoms: Edema Coughing Vomiting Dizziness Loose stools Palpitations Urinary difficulty Heavy sensation in the head Abdominal pain that worsens with cold Deep aching and heaviness in the extremities

Trigeminal neuralgia might be due to Spleen or Kidney Yang Deficiency if the condition is paired with typical pattern symptoms such as abdominal pain that worsens with cold, urinary difficulty, deep aching and heaviness in the extremities and dizziness. Similarly, patients with Spleen or Kidney Yang Deficiency typically exhibit deep (Chen) or fine (Xi) pulses as well as a pale tongue.

Read more about Spleen or Kidney Yang Deficiency here

The Spleen is a so-called "Zang" Organ. Learn more about the Spleen in Chinese Medicine

Spleen Yang Deficiency

Pulse type(s): Deep (Chen), Slow (Chi), Weak (Ruo)

Tongue color: Pale

Recommended herbal formulas: Zhen Wu Tang, Bu Zhong Yi Qi Tang, Yi Huang Tang

Symptoms: Edema Fatigue Cold limbs Weak Limbs Loose stools Poor appetite Feeling of cold Vagina discharge

Generally speaking, Spleen Yang Deficiency often develops from Spleen Qi Deficiency, but it is more extensive and severe, with additional Cold symptoms, such as a cold feeling and cold limbs. It is because Spleen Yang fails to warm the body and Organs. Because of that, the body metabolism get slower and some food are not digested properly and passes directly into the stools. Since the Spleen fails to perform the function of transforming and transporting fluids, the circulation of Body Fluids is disturbed, causing symptoms such as Oedema, vaginal discharge and Lung mucus.

The causes are similar to these of Spleen Qi Deficiency, along with surplus consumption of cold, raw foods and drinks and overexposure to cold damp environments and climates.

Read more about Spleen Yang Deficiency here

Yang Deficiency with Cold-Damp

Pulse type(s): Choppy (Se), Deep (Chen), Minute (Wei), Slow (Chi)

Tongue coating: Thin white coating

Recommended herbal formula: Fu Zi Tang

Symptoms: No thirst Cold extremities Generalized body pain Aching bones and joints Aversion to cold (especially at the back)

Trigeminal neuralgia might be due to Yang Deficiency with Cold-Damp if the condition is paired with typical pattern symptoms such as generalized body pain, aching bones and joints, cold extremities and no thirst. Similarly, patients with Yang Deficiency with Cold-Damp typically exhibit choppy (Se), deep (Chen), minute (Wei) or slow (Chi) pulses as well as a tongue with thin white coating.

Read more about Yang Deficiency with Cold-Damp here

The Kidneys is a so-called "Zang" Organ. Learn more about the Kidneys in Chinese Medicine

Kidney Yin Deficiency

Pulse type(s): Rapid (Shu), Empty (Xu), Floating (Fu)

Tongue coating: Complete absence of coating

Tongue color: Red

Tongue shape: Cracked

Recommended herbal formulas: Liu Wei Di Huang Wan, Yu Nu Jian

Symptoms: Vertigo Tinnitus Dizziness Dry mouth Bone ache Back pain Dry throat Poor memory Night sweats Nocturnal emissions

Kidney Yin Deficiency causes false Heat symptoms, such as night sweats, thirst and five palm heat. These signs are from a depletion of Body Fluids and Essence. It can also lead to an insufficient amount of Marrow to fill the Brain, causing poor memory and dizziness. Yin Deficiency of the Kidneys is often paired together with Deficient Liver Yin and/or Deficient Lung Yin.

It can be caused by overwork over a period of several years. Another common cause is excessive sexual activity that consumes both Kidney Essence and Kidney Yin. Other causes include chronic long term illness, consumption of Body Fluids by Heat, prolonged blood loss, overdosage of Yang tonic herbs, smoking and Kidney-depleting foods such as coffee, alcohol, sugar and fruit juices.

Read more about Kidney Yin Deficiency here

The Pericardium is a so-called "Zang" Organ. Learn more about the Pericardium in Chinese Medicine

Pericardium Blood Stagnation

Pulse type(s): Knotted (Jie), Wiry (Xian)

Tongue color: Bluish-Purple

Recommended herbal formula: Xue Fu Zhu Yu Tang

Symptoms: Chest pain Purple lips Palpitations Purple nails Painful period Hypochondriac pain Shortness of breath Dark clots in menstrual blood Feeling of oppression of the chest

Trigeminal neuralgia might be due to Pericardium Blood Stagnation if the condition is paired with typical pattern symptoms such as chest pain, hypochondriac pain, palpitations and painful period. Similarly, patients with Pericardium Blood Stagnation typically exhibit knotted (Jie) or wiry (Xian) pulses as well as a bluish-purple tongue.

Read more about Pericardium Blood Stagnation here

The Stomach is a so-called "Fu" Organ. Learn more about the Stomach in Chinese Medicine

Stomach Blood Stagnation

Pulse type(s): Wiry (Xian)

Tongue color: Bluish-Purple

Recommended herbal formula: Xue Fu Zhu Yu Tang

Symptoms: Nausea Vomiting Epigastric pain Vomiting of blood

Trigeminal neuralgia might be due to Stomach Blood Stagnation if the condition is paired with typical pattern symptoms such as epigastric pain, nausea, vomiting and vomiting of blood. Similarly, patients with Stomach Blood Stagnation typically exhibit wiry (Xian) pulses as well as a bluish-purple tongue.

Read more about Stomach Blood Stagnation here

The eight herbal formulas that might help with trigeminal neuralgia

Wu Ling San

Source date: 220 AD

Number of ingredients: 5 herbs

Key actions: Promotes urination,. Warms the Yang. Strengthens the Spleen. Promotes Qi transformation function. Drains Dampness. Clears edema.

Why might Wu Ling San help with trigeminal neuralgia?

Because it is a formula often recommended to help with the patterns Phlegm, Spleen Deficiency with Dampness and Phlegm in the Lower Burner which are sometimes associated with trigeminal neuralgia. If any of these patterns look like something you might suffer from, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Wu Ling San here

Zhen Wu Tang

Source date: 220 AD

Number of ingredients: 5 herbs

Key actions: Warms and tonifies the Yang and Qi of the Spleen and Kidneys. Eliminates Dampness.

Why might Zhen Wu Tang help with trigeminal neuralgia?

Because it is a formula often recommended to help with the patterns Spleen or Kidney Yang Deficiency, Exterior Cold invading the Interior and Spleen Yang Deficiency which are sometimes associated with trigeminal neuralgia. If any of these patterns look like something you might suffer from, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Zhen Wu Tang here

Yu Nu Jian

Source date: 1624 AD

Number of ingredients: 5 herbs

Key actions: Drains Heat from the Stomach. Nourishes Yin.

Why might Yu Nu Jian help with trigeminal neuralgia?

Because it is a formula often recommended to help with the patterns Stomach Fire or Stomach Heat and Kidney Yin Deficiency which are sometimes associated with trigeminal neuralgia. If any of these patterns look like something you might suffer from, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Yu Nu Jian here

Xue Fu Zhu Yu Tang

Source date: 1830 AD

Number of ingredients: 11 herbs

Key actions: Invigorates the Blood. Dispels blood Stagnation. Spreads the Liver Qi. Unblocks the channels.

Why might Xue Fu Zhu Yu Tang help with trigeminal neuralgia?

Because it is a formula often recommended to help with the patterns Pericardium Blood Stagnation and Stomach Blood Stagnation which are sometimes associated with trigeminal neuralgia. If any of these patterns look like something you might suffer from, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Xue Fu Zhu Yu Tang here

Tao He Cheng Qi Tang

Source date: 220 AD

Number of ingredients: 5 herbs

Key actions: Dispels Heat and. Eliminates Blood Stagnation.

Why might Tao He Cheng Qi Tang help with trigeminal neuralgia?

Because it is a formula often recommended to help treat Heat and Blood Stagnation in the Lower Burner, a pattern sometimes associated with trigeminal neuralgia. If it looks like you might suffer from Heat and Blood Stagnation in the Lower Burner, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Tao He Cheng Qi Tang here

Da Huang Fu Zi Tang

Source date: 220 AD

Number of ingredients: 3 herbs

Key actions: Warms the Interior. Disperses Cold. Unblocks the bowels. Alleviates pain.

Why might Da Huang Fu Zi Tang help with trigeminal neuralgia?

Because it is a formula often recommended to help treat Exterior Cold invading the Interior, a pattern sometimes associated with trigeminal neuralgia. If it looks like you might suffer from Exterior Cold invading the Interior, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Da Huang Fu Zi Tang here

Qing Wei San

Source date: 1336 AD

Number of ingredients: 5 herbs

Key actions: Drains Stomach Fire. Cools the Blood. Nourishes the Yin.

Why might Qing Wei San help with trigeminal neuralgia?

Because it is a formula often recommended to help treat Stomach Fire or Stomach Heat, a pattern sometimes associated with trigeminal neuralgia. If it looks like you might suffer from Stomach Fire or Stomach Heat, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Qing Wei San here

Fu Zi Tang

Source date: 220 AD

Number of ingredients: 5 herbs

Key actions: Warms the Meridians. Assists the Yang. Dispels Cold. Transforms Dampness.

Why might Fu Zi Tang help with trigeminal neuralgia?

Because it is a formula often recommended to help treat Yang Deficiency with Cold-Damp, a pattern sometimes associated with trigeminal neuralgia. If it looks like you might suffer from Yang Deficiency with Cold-Damp, this formula might help (although please seek confirmation with a professional practitioner beforehand).

Read more about Fu Zi Tang here