徐 脉左浮弦数。痰多。脘中不爽。烦则火升眩晕。静坐神识稍安。议少阳阳明同治法。（痰火）
羚羊角 连翘 香豆豉 广皮白 半夏曲 黑山栀
某 痰火风在上。舌干头眩。
天麻 钩藤 菊花 橘红 半夏曲 茯苓 山栀 花粉
某 酒客中虚。痰晕。二陈加术白蒺藜钩藤天麻。
江（五十）脉弦动。眩晕痰多。胸痹窒塞。此清阳少旋。内风日沸。当春地气上升。最虑风痱。（内风挟痰）
明天麻 白蒺藜 桂枝木 半夏 橘红 茯苓 苡仁 炙草
又 头额闷胀。痰多作眩。外台茯苓饮加羚羊角桂枝竹沥姜汁法丸。
吴（四五）诊脉芤弱。痰多眩晕。心神过劳。阳升风动。不可过饮助升。治痰须健中。熄风可缓晕。
九蒸白术 炒杞子 白蒺藜 茯苓 菊花炭
周 内风挟痰眩晕。吐出清水。
半夏 茯苓 广皮 天麻 钩藤 菊花
张 肝风内沸。劫烁津液。头晕。喉舌干涸。（肝风）
大生地 天冬 麦冬 萸肉 阿胶 生白芍
陈 肝风动逆不熄。头晕。
九制首乌（四两） 甘菊炭（一两） 杞子（二两） 桑椹子（二两） 黑芝麻（二两） 巨胜子
（一两半） 牛膝（一两半） 茯神（二两） 青果汁法丸。
洪（四十）内风逆。头晕。
经霜桑叶（一钱） 炒黄甘菊花炭（一钱） 生左牡蛎（三钱） 黑 豆皮（三钱）
徽州黑芝麻（二钱） 茯神（一钱半）
某 两寸脉浮大。气火上升。头眩。甚则欲呕吐。厥阴上干。久则阳明失降。土被木克。脾胃俱伤。
先当镇肝阳。
制首乌 豆皮 炒杞子 柏子仁 紫石英 茯神 天冬 南枣
某 操持惊恐。相火肝风上窜。目跳头晕。阴弱欲遗。脉左弦劲。右小平。
生地 白芍 丹皮 钩藤 天麻 白蒺藜 黄菊花 橘红
王（六三）辛甘寒。眩晕已缓。此络脉中热。阳气变现。内风上冒。是根本虚在下。热化内风在上。上实
下虚。先清标恙。（络热）
羚羊角 元参心 鲜生地 连翘心 郁金 石菖蒲
又 照前方去菖蒲郁金加川贝花粉。
某（二四）晕厥。烦劳即发。此水亏不能涵木。厥阳化风鼓动。烦劳阳升。病斯发矣。据述幼年即然。药
饵恐难杜绝。（阴虚阳升）
熟地（四两） 龟版（三两） 牡蛎（三两） 天冬（一两半） 萸肉（二两） 五味（一两）
茯神（二两） 牛膝（一两半） 远志（七钱） 灵磁石（一两）
田（二七）烦劳。阳气大动。变化内风。直冒清空。遂为眩晕。能食肤充。病不在乎中上。以介类沉潜真
阳。咸酸之味为宜。
淡菜胶 龟版胶 阿胶 熟地 萸肉 茯苓 川斛 建莲 山药浆丸。
严（四五）营虚。内风逆。心悸头晕。（营血虚）
炒杞子 柏子仁 三角胡麻 川斛 生左牡蛎 冬桑叶
李（七三）高年颇得纳谷安寝。春夏以来。头晕。跗肿。不能健步。此上实下虚。肾气衰。不主摄纳。肝风
动。清窍渐蒙。大凡肾宜温。肝宜凉。温纳佐凉。乃复方之剂。（下虚）
附都气加车前淡天冬建莲丸。
经云。诸风掉眩。皆属于肝。头为六阳之首。耳目口鼻。皆系清空之窍。所患眩晕者。非外来
之邪。乃肝胆之风阳上冒耳。甚则有昏厥跌仆之虞。其症有夹痰。夹火。中虚。下虚。治胆。治
胃。治肝之分。火盛者。先生用羚羊山栀连翘花粉元参鲜生地丹皮桑叶。以清泄上焦窍
络之热。此先从胆治也。痰多者必理阳明。消痰如竹沥姜汁。菖蒲橘红。二陈汤之类。中虚
则兼用人参。外台茯苓饮是也。下虚者。必从肝治。补肾滋肝。育阴潜阳。镇摄之治是也。至
于天麻钩藤菊花之属。皆系熄风之品。可随症加入。此症之原。本之肝风。当与肝风中风
头风门合而参之。（华岫云）
徐评 眩晕清火养肝。固为正治。但阳气上升。至于身体不能自主。此非浮火之比。古人必用
金石镇坠之品。此则先生所未及知也。忆余初至郡中治病。是时喜用唐人方。先生见之。谓人
曰。有吴江秀才徐某。在外治病。颇有心思。但药味甚杂。此乃无师传授之故。以后先生得宋板
外台秘要读之。复谓人曰。我前谓徐生立方无本。谁知俱出外台。可知学问无穷。读书不可轻
量也。先生之服善如此。犹见古风。所谓药味杂。即指金石品也。因附记于此。
Mr. Xu: The pulse on the left is floating, wiry, and rapid. There is excessive phlegm. A sensation of discomfort in the epigastrium. When irritable, fire rises causing vertigo; sitting quietly brings slight relief to the spirit and mind. It is proposed to treat the Shaoyang and Yangming meridians simultaneously. (Pathogenesis: Phlegm-Fire)
Antelope Horn (Lingyangjiao), Forsythia Fruit (Lianqiao), Fermented Soybean (Xiangdouchi), White Peel of Tangerine Fruit (Guangpi Bai), Fermented Pinellia Rhizome (Banxia Qu), Gardenia Fruit (Heishanzhi).
Certain patient: Phlegm-fire and wind are above. The tongue is dry with vertigo.
Gastrodia Tuber (Tianma), Uncaria Ramulus cum Uncis (Gouteng), Chrysanthemum Flower (Juhua), Orange Peel (Juhong), Fermented Pinellia Rhizome (Banxia Qu), Poria (Fuling), Gardenia Fruit (Shanzhi), Trichosanthes Root (Huafen).
Certain patient: A chronic drinker has deficiency in the Middle Jiao. Vertigo caused by phlegm. Erchen Decoction (Two-Chen Decoction) added with Atractylodes Macrocephala Rhizome (Baizhu), Tribulus Fructus (Bajili), Uncaria Ramulus cum Uncis (Gouteng), and Gastrodia Tuber (Tianma).
Mr. Jiang (50 years old): The pulse is wiry and moving. Vertigo with excessive phlegm. Chest bi syndrome with a feeling of obstruction. This indicates that Clear Yang Qi fails to rotate properly, and internal wind is boiling day by day. During spring when earth qi rises, one should most fear Fengfei (stroke with hemiplegia or aphasia). (Pathogenesis: Internal Wind carrying Phlegm)
Premium Gastrodia Tuber (Tianma), Tribulus Fructus (Bajili), Cinnamon Twig Wood (Guizhi Mu), Pinellia Rhizome (Banxia), Orange Peel (Juhong), Poria (Fuling), Coix Seed (Yiren), Honey-fried Licorice Root (Zhigancao).
Second consultation: Stuffy and distended head and forehead. Excessive phlegm causing vertigo. Use Fuling Yin (Poria Drink) from *Waitai Mi Yao* (*Secrets of the Outer Palace*), adding Antelope Horn (Lingyangjiao), Cinnamon Twig (Guizhi), Bamboo Sap (Zhuli), and Ginger Juice (Jiangzhi), processed into pills.
Mr. Wu (45 years old): The pulse is knotted (Kou) and weak. Excessive phlegm and vertigo. The heart spirit is overworked. Yang rises and wind moves. One must not drink excessively to aid the rising of Yang. Treating phlegm requires strengthening the Middle Jiao. Extinguishing wind can relieve vertigo.
Nine-steamed Atractylodes Macrocephala Rhizome (Baizhu), Stir-fried Lycium Fruit (Qizi), Tribulus Fructus (Bajili), Poria (Fuling), Charred Chrysanthemum Flower (Juhua Tan).
Mr. Zhou: Internal wind carrying phlegm causes vertigo. Vomiting clear water.
Pinellia Rhizome (Banxia), Poria (Fuling), Broad-leafed Citrus Peel (Guangpi), Gastrodia Tuber (Tianma), Uncaria Ramulus cum Uncis (Gouteng), Chrysanthemum Flower (Juhua).
Mr. Zhang: Liver wind boils internally, consuming and drying up body fluids. Dizziness. Dryness of the throat and tongue. (Pathogenesis: Liver Wind)
Large Rehmannia Root (Dishengdi), Asparagus Tuber (Tiandong), Ophiopogon Tuber (Maidong), Cornus Fruit (Yurou), Donkey-hide Gelatin (Ejiao), Raw White Peony Root (Baishao).
Mr. Chen: Liver wind moves and rebels but is not extinguished. Dizziness.
Nine-processed Polygonum Multiflorum Root (He Shouwu, 4 liang), Charred Sweet Chrysanthemum (Ganju Tan, 1 liang), Lycium Fruit (Qizi, 2 liang), Mulberry Fruit (Sangshenzi, 2 liang), Black Sesame Seed (Heimazhi, 2 liang), Giant Sesame (Jushengzi, 1.5 liang), Achyranthes Bidentata Root (Niuxi, 1.5 liang), Poria with Hostwood (Fushen, 2 liang). Processed into pills using Green Plum Juice.
Mr. Hong (40 years old): Internal wind rebels. Dizziness.
Frost-exposed Mulberry Leaf (Sangye, 1 qian), Stir-fried Yellow Sweet Chrysanthemum Char (Huangju Tan, 1 qian), Raw Left-side Oyster Shell (Muli, 3 qian), Black Bean Skin (Doupi, 3 qian), Huizhou Black Sesame Seed (Heimazhi, 2 qian), Poria with Hostwood (Fushen, 1.5 qian).
Certain patient: Both Cun positions of the pulse are floating and large. Qi and fire rise upward. Vertigo. Severe cases lead to nausea/vomiting. Jueyin (Liver) channel interferes upwards. Over time, Yangming (Stomach) loses its descending function. Earth is overcome by Wood. Spleen and Stomach are both injured.
One should first suppress Liver Yang.
Processed Polygonum Multiflorum Root (Zhi Shouwu), Bean Skin (Doupi), Stir-fried Lycium Fruit (Chao Qizi), Biota Seed (Baiziren), Purple Quartz (Zishi), Poria with Hostwood (Fushen), Asparagus Tuber (Tiandong), Southern Date (Nanzao).
Certain patient: Mental exertion and fright cause Ministerial Fire and Liver wind to rush upward. Eye twitching and dizziness. Yin is weak with desire for emission. The pulse is wiry and forceful on the left, slightly flat and small on the right.
Rehmannia Root (Shengdi), White Peony Root (Baishao), Moutan Bark (Danpi), Uncaria Ramulus cum Uncis (Gouteng), Gastrodia Tuber (Tianma), Tribulus Fructus (Bajili), Yellow Chrysanthemum (Huangjuhua), Orange Peel (Juhong).
Mr. Wang (63 years old): Using Acrid-Sweet-Cold method. Vertigo has eased. This is heat in the collaterals. Yang Qi manifests pathology. Internal wind rushes upward. The root deficiency is in the Lower Jiao. Heat transforms into internal wind in the Upper Jiao. Upper excess and Lower deficiency. First clear the branch symptoms. (Pathogenesis: Collateral Heat)
Antelope Horn (Lingyangjiao), Scrophularia Root (Yuanshenxin), Fresh Rehmannia Root (Xianshengdi), Forsythia Heart (Lianqiaoxin), Curcuma Tuber (Yujin), Acorus Tuber (Shichangpu).
Second consultation: Follow the previous prescription, remove Acorus (Shichangpu) and Curcuma (Yujin), add Fritillaria Bulb (Chuanbei) and Trichosanthes Root (Huafen).
Certain patient (24 years old): Syncope. Triggered by mental fatigue. This is Kidney Water deficiency failing to nourish Liver Wood. Jueyang transforms into wind and agitates. Mental fatigue causes Yang to rise, and the disease arises. According to history, this has been present since youth. Medication may be difficult to completely prevent recurrence. (Pathogenesis: Yin Deficiency with Yang Rising)
Prepared Rehmannia Root (Shudi, 4 liang), Tortoise Plastron (Guiban, 3 liang), Oyster Shell (Muli, 3 liang), Asparagus Tuber (Tiandong, 1.5 liang), Cornus Fruit (Yurou, 2 liang), Schisandra Berry (Wuweizi, 1 liang), Poria with Hostwood (Fushen, 2 liang), Achyranthes Bidentata Root (Niuxi, 1.5 liang), Polygala Root (Yuanzhi, 7 qian), Spirit Magnetite (Lingcishi, 1 liang).
Mr. Tian (27 years old): Mental fatigue. Yang Qi moves greatly, transforming into internal wind. Rushing directly to the clear cavities of the head, resulting in vertigo. Appetite is good, skin and flesh are full. The disease is not in the Middle or Upper Jiao. Use shellfish-type materials to sink and submerge True Yang. Salty and sour flavors are appropriate.
Edible Mussel Gel (Dancaijiao), Tortoise Plastron Gel (Guibanjiao), Donkey-hide Gelatin (Ejiao), Prepared Rehmannia Root (Shudi), Cornus Fruit (Yurou), Poria (Fuling), Dendrobium Stem (Chuanhu), Jian Lotus Seed (Jianlian), Yam Paste (Shanyao) processed into pills.
Mr. Yan (45 years old): Ying Blood deficiency. Internal wind rebels. Palpitations and dizziness. (Pathogenesis: Ying Blood Deficiency)
Stir-fried Lycium Fruit (Qizi), Biota Seed (Baiziren), Triangular Sesame (Sanjiao Huma), Dendrobium Stem (Chuanhu), Raw Left-side Oyster Shell (Muli), Winter Mulberry Leaf (Dongsangye).
Mr. Li (73 years old): Advanced age but able to eat well and sleep peacefully. Since spring and summer, dizziness. Edema of the dorsum of the foot. Unable to walk steadily. This is Upper excess and Lower deficiency. Kidney Qi is declining, failing to govern reception. Liver wind moves, clouding the clear orifices gradually. Generally, the Kidney should be warmed, and the Liver cooled. Warming and receiving assisted by cooling constitutes a compound formula. (Pathogenesis: Lower Deficiency)
Formula based on Duqi Wan (Six-Ingredient Pill with Rehmannia) added with Alisma Rhizome (Cheqianzi), Light Asparagus Tuber (Dan Tiandong), and Jian Lotus Seed (Jianlian) processed into pills.
The Classic states: "All wind diseases causing tremors and vertigo belong to the Liver." The head is the summit of the Six Yang channels. The eyes, ears, mouth, and nose are all clear orifices. The vertigo suffered from is not due to external pathogens, but rather the uprising of Liver-Gallbladder Wind-Yang. In severe cases, there is danger of syncope and falling. Symptoms may involve carrying Phlegm, carrying Fire, Middle Deficiency, or Lower Deficiency. Treatment targets the Gallbladder, Stomach, or Liver respectively. For excessive Fire, Mr. Ye first uses Antelope Horn, Gardenia, Forsythia, Trichosanthes Root, Scrophularia, Fresh Rehmannia, Moutan Bark, and Mulberry Leaf to clear and drain heat from the upper jiao orifices and collaterals. This treats from the Gallbladder perspective. For excessive phlegm, one must regulate the Yangming, eliminating phlegm using Bamboo Sap, Ginger Juice, Acorus, Orange Peel, Erchen Decoction, etc. For Middle Deficiency, Ginseng is added; Fuling Yin from *Waitai Mi Yao* is an example. For Lower Deficiency, treatment must target the Liver, tonifying the Kidney and nourishing the Liver, nurturing Yin to submerge Yang, using sedative and stabilizing treatments. As for Gastrodia, Uncaria, and Chrysanthemum, these are wind-extinguishing herbs that can be added according to symptoms. The origin of this condition lies in Liver Wind; it should be studied together with the chapters on Wind Stroke and Headache. (Commentary by Hua Xiuyun)
Mr. Xu's Commentary: Clearing fire and nourishing the Liver for vertigo is indeed the correct treatment. However, when Yang Qi rises to the point where the body cannot control itself, this is not comparable to floating fire. Ancients would definitely use heavy mineral and stone sedatives. This was something Mr. Ye had not yet realized at that time. I recall when I first went to the prefecture to practice medicine, I liked using Tang dynasty formulas. Mr. Ye saw this and said to others, "There is a scholar named Xu from Wujiang practicing outside. He has considerable thought, but his prescriptions contain too many mixed herbs. This is because he lacks formal transmission." Later, after Mr. Ye read the Song edition of *Waitai Mi Yao*, he said to others, "I previously said Mr. Xu's prescriptions lacked a foundation, who knew they all came from *Waitai*? This shows learning is infinite; one must not underestimate reading." Mr. Ye's willingness to accept advice is so commendable, reflecting ancient virtues. By "mixed herbs," he referred to mineral and stone preparations. Therefore, I record this here.