Fainting


 * IBIS:**

Definition:
Includes sudden loss, near-complete loss, and feeling of impending loss of consciousness. The medical term is "syncope".

Etiology:
The attack almost always occurs while the patient is in the upright position. There are many causes. The condition usually resolves quickly and spontaneously once the patient is put in, or falls to, a horizontal position, and blood flow, no longer hindered by gravity, once more flows fully to the brain.

• vasovagal: This is the typical faint that occurs in healthy people with no underlying condition. It can frequently be recurrent when the individual is faced with the same stimuli (e.g. a small, warm room), or can be due to an emotional shock, intense pain, and as a response to trauma. Other factors that might precipitate a faint in a susceptible person include being bedridden, fasting, anemia, and poor physical condition. Physiologically, there is a significant drop in arterial pressure concurrent with venous pooling of blood and tachycardia; next comes bradycardia which further reduces cerebral blood flow and initiates the faint. Almost always the loss of consciousness occurs gradually enough for the person to get to the ground without injuring himself. Once on the ground, awareness usually resumes quickly, although the faint may last up to a half hour, but the patient may still feel weak, and rising too soon may bring on another faint.

• postural hypotension with syncope: This type of faint occurs in patients who have a chronic disorder or variable instability of vasomotor reflexes. The most common reason for this type of syncope is use of drugs that impair autonomic reflexes (typically excessive doses of hypotensive medications, monoamine oxidase inhibitors, the chemotherapy drug vincristine, barbiturates, alcohol, quinidine and L-dopa). The fall of blood pressure on arising is due to a loss of vasoconstriction reflexes in resistance and the dependent venous capacitance vessels resulting in a decrease of venous return and a drop in cardiac output. The characteristics of the faint are similar to that of the vasovagal type; the distinguishing feature is that the patient experiences the attacks upon rising from a sitting or stooping position and not after having stood awhile. Causes for this include the drugs listed above as well as familial tendencies, and the dysautonomias.

• syncope of cardiac origin: This usually results from a sudden lack of cardiac output, usually due to an arrhythmia. In normal people ventricular pulse rates below 35-40 beats per minutes or above 185 beats per minute are usually needed to induce a cerebral blood flow disorder causing syncope. The most common arrhythmia is complete atrioventricular block, and combined with subsequent fainting, is known as the Stokes-Adams-Morgagni Syndrome. It is not necessarily associated with the upright position. Other cardiac problems that can cause syncope include massive myocardial myofarction, stenosis (leads to exertional fainting), Tetralogy of Fallot, and primary pulmonary hypertension.

• cardiac sinus syncope: Massage of one or both of the cardiac sinuses, especially in the elderly individual, can cause cardiac slowing and/or decreased arterial pressure. This type of syncope may occur by turning the head, tight collars, shaving over the sinus regions, or, spontaneously without a clear stimulus. The typical patient is male, and the faint usually occurs in the upright position.

Nutrition:
therapeutic foods: • increase foods rich in Calcium, Phosphorus, Manganese, Sulfur, Iodine, tryptophan (Jensen, p. 63) • egg yolk, kale, celery, fish, raw goat's milk, veal joint broth, cod roe, rice polishings, brewer's yeast, nutritional yeast (Jensen, p. 63)

fresh juices: • celery, carrot, prune (Jensen, p. 63) • prune and rice polishings (Jensen, p. 63) • raw goat's milk and 1 tsp. sesame, sunflower, or almond butter, 1 tsp. honey and sliver of avocado (Jensen, p. 63) • black cherry and egg yolk (Jensen, p. 63)

avoid: • caffeine, simple carbohydrates

Botanicals
• Aletris farinosa: fainting spells in the nausea of pregnancy (Ellingwood, p. 480) • Crataegus oxyacantha: improves circulation (Ellingwood, p. 218) • Ginkgo biloba (standardized extract): increases cerebral circulation • Lavandula vera: essential oil with carbonate of ammonium as a smelling salt; use tincture for tendency to faint in asthenic individuals (Felter, p. 443) • Selenicereus grandiflorus (toxic): associated with heart disorders; improves circulation to brain (Ellingwood, p. 213) • Valeriana spp.: stimulant-tonic (Felter and Lloyd, p. 2042) See vertigo

Chinese Formulae
» non-emergency care: • Saussurea and Cardamon C. (Xiang Sha Liu Jun Zi Tang): Qi Xu (Deficiency) (Hsu, 1980, p. 234; Yeung, p. 253; Dharmananda, 1986, p. 187; Bensky and Barolet, p. 238) • Ginseng Nutritive C. (Ren Shen Yang Ying Tang): Xue Xu (Blood Deficiency) (Hsu, 1980, p. 239; Yeung, p. 182; Dharmananda, 1986, p. 407; Bensky and Barolet, p. 260) • Dao Tan Tang: Liver Wind Stirring with Spleen Distressed by Dampness. (Yeung, p. 82; Bensky and Barolet, p. 448)

Acupuncture
after assessing the person and palpating, consider these patterns: Disruption in the flow of Qi through the channels, which temporarily prevents the Xue (Blood) and Qi from circulating to the head, and the Yang Qi from reaching the extremities. The Wei (Protective) and Ying (Constructive) Qi become rebellious in the channels. Qi Xu (Deficiency); Xue Xu (Blood Deficiency); Liver Wind Stirring with Spleen Distressed by Dampness

» illustrative combinations: • LI-10 and GV-26; Lu-9, TW-2 and Lv-1; Ht-9 and PC-9 for syncope (Mann, p. 121) • GV-15, PC-8, Sp-6, Kd-1, Kd-3, CV-12, GB-30, St-36 and LI-4 are the Nine Needles for Returning the Yang (Li, p. 627-628; Ellis, et al, 1988, p. 66) • SI-3 joined to PC-8 (-): revive consciousness; clear the Shen; transform Heart Phlegm and dispel Wind Phlegm

Homeopathy
• Ambra grisea: asthenic and nervous; timid • Ignatia: contradictory, mental hypersensitivity; paradoxical change of mood at the least variation in the emotions • Moschus: the least cause provokes it in hypersensitive and nervous individuals, especially females; very changeable mood; exaggeration always; hysteria • Nux moschata: cerebral asthenia; fainting with the least cause (pain, emotion, long-standing complaints, cold, etc.); extreme dryness of mucous membranes • Valeriana officinalis: nervous with spasm, hysteria, excitations and joy, insomnia • Veratrum album: especially during menses; after fear; extreme coldness and weakness

Subtle Support
• notes: A#, B, C, D#, E, G, G#

• chords: diminished 8th, C Major, D# Major, G# Major (Gimbel, p. 116)

Mind/Body
• Fear; can't cope; blacking out. (Hay, 1984, p. 164)

• Liver ~ Gan is the home of the Hun (Ethereal Soul); it relates to decisiveness, control, and the principle of emergence; stores the Xue (Blood); maintains smooth flow of Qi and Xue (Blood); reflects emotional harmony and movement; and expresses itself in the nervous system. » Healthy expressions are kindness, spontaneity, and ease of movement. » Liver Xu (Deficiency) signs include impotence; frigidity; pain in thighs, pelvic region, and throat; ready tendency to "the blahs" (Seem, p. 28); timidity; depression; irritability; vertigo; pruritus; dry skin and/or tendons; asthma; aching at the waist; hernia; and difficulty raising head up and down. » Liver Wind derives from Liver Yin Xu (Deficiency) and/or Liver Xue Xu (Blood Deficiency) and their subsequent inability to embrace the Yang, and can manifest as joint stiffness, dizziness, tremor, paralysis, convulsions, rashes, itching, and neurological problems. » Liver Qi Stagnation reflects and accentuates emotional constraint as the Liver's function of facilitating smooth flow in the body is constricted. Stagnation is associated with frustration, irritability, tension, and feeling stuck. With time this pattern tends to produce a gloomy emotional state of constant resentment, repressed anger or depression, along with tightness in the chest, frequent sighing, abdominal tension or distension, and/or a feeling of a lump in the throat with difficulty in swallowing. (Maciocia, p. 216)
 * Chinese psychophysiology:**

• Heart ~ Xin houses the Shen (Spirit) and reveals itself through the brightness in the eyes; governs Fire; rules the Xue (Blood) and its vessels and directs the circulation; and relates to the integration of the organs and the personality. » Healthy expressions are warmth, vitality, excitement, inner peace, love, and joy. » Heart Xu (Deficiency) signs include sadness; absence of laughter; depression; fear; anxiety; shortness of breath (Seem, p. 28); cold feeling in the chest and limbs; palpitations; cold sweat; inability to speak; memory failure; nocturnal emissions; and restless sleep. » The Heart is the Emperor of the bodily realm so that when the Heart is disturbed all the other organs will be disrupted.

• Spleen ~ Pi governs digestion and manifests in the muscle tissues; transforms food into Qi and Xue (Blood); governs the Xue (Blood) and holds it in the vessels; resolves Dampness and Phlegm; maintains upbearing; and relates to the ability to assimilate, stabilize, and feel centered and balanced. » Healthy expressions are fairness, openness, deep thinking, and reminiscence. » Spleen Xu (Deficiency) signs include slightness (deficient "form"); abundant elimination; morning fatigue; cold, wet feet (Seem, p. 28); abdomen taut and distended like a drum; craving for sweets; flatulence; nausea; mild edema; memory failure; heavy feeling in legs; pale lips; chronic diarrhea; muscular weakness; and, indirectly, obesity. » The excessive use of the mind in thinking, studying, concentrating, and memorizing over a long period of time tends to weaken the Spleen and may lead to Xue Yu (Blood Stasis). This also includes excessive pensiveness and constant brooding. (Maciocia, p. 241) Likewise, inadequate physical exercise and excess consumption of sweet and/or Cold foods will also deplete the Spleen. Environmentally, the Spleen is highly susceptible to attack from external Dampness and Cold.