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(Attached: Dizziness of the Eyes, Shaking of the Head)

Headache belongs to the Taiyang syndrome. If there is no headache but only suffering from vertigo/dizziness (Touxuan), it is mostly due to Yangming disease. Whenever a disease begins with immediate dizziness/vertigo, the causes may be Wind, Heat, or Phlegm. As stated in the classic text: "In Yangming disease, if there is only dizziness/vertigo without aversion to cold, the patient can eat and cough; such a person must have a sore throat." In Yangming disease, the ability to eat indicates Wind strike (Zhongfeng, invasion by wind pathogen); this is dizziness caused by wind. The text also states: "In Yangming disease, if the pulse is slow, food cannot be taken to fullness; after eating fully, there is slight irritability and dizziness, and urination will be difficult. This is about to develop into Grain Jaundice (Gu Dan). Stagnant heat in the interior leads to jaundice." This is dizziness caused by heat. Extending this reasoning to Phlegm, phlegm combined with wind is Wind-Phlegm, and phlegm combined with heat is Heat-Phlegm. All phlegm syndromes must have a cause for their generation; examining the cause to treat the root of phlegm production will naturally eliminate the phlegm. These are the general principles for treating excess syndromes.

Regarding Shaoyang disease, the symptom is dizziness of the eyes (Muxuan). There is a distinction between dizziness of the eyes and dizziness/vertigo of the head, but both are ultimately caused by the rising of Yang-Heat.

If Taiyang disease is mistakenly treated with sweating or purging methods, leading to dizziness/vertigo due to deficiency causing mental clouding (Mao), the text says: "In Taiyang disease, after inducing sweat, if the condition does not resolve, the patient still has fever, palpitations in the epigastrium, dizziness/vertigo, body tremors, and feels as if they want to fall to the ground; Zhenwu Tang should be used." It also states: "After Shanghan (Cold Damage) is treated with emesis or purging, if there is rebellious fullness in the epigastrium, Qi rushing up to the chest, dizziness upon standing, and a deep, tight pulse, further sweating will disturb the collaterals, causing the body to tremble and sway; Ling Gui Zhu Gan Tang (Poria, Cinnamon Twig, Atractodes Macrocephala, and Licorice Decoction) should be used." This is a pattern of deficiency-cold, requiring urgent warming of the interior and tonification of deficiency, yet one might still fear that the treatment is insufficient.

In summary, sweating and purging methods must not be misapplied. The text warns: "If Dongqi (pulsating mass/sensation) is on the left, do not induce sweat; doing so causes dizziness/vertigo. If Dongqi is on the right, do not purge; doing so causes dizziness/vertigo. If Dongqi is below, do not purge; doing so causes sudden dizziness/vertigo upon rising." Zhang Zhongjing had issued these profound warnings early on.

Furthermore, in Shaoyin disease, if diarrhea stops but dizziness/vertigo occurs, accompanied by frequent episodes of mental clouding/fainting, the prognosis is fatal. If severe sweating is induced in various adverse conditions, leading to disordered speech and dizziness of the eyes, this is also a fatal sign. This represents the exhaustion of Yin fluids and the floating and detachment of deficient Yang, which cannot be rescued.

Shaking of the head (Yaotou) is distinct from dizziness/vertigo. The text states: "If only the head and face shake, with sudden jaw stiffness (Koujin) and opisthotonos (back arching), this is Jing disease (Spasm Disease)." See the chapter on Spasm Disease for details. There is also shaking of the head indicating pain in the interior; this is not necessarily an adverse (fatal) sign. However, if Yang remains alone while Yin is exhausted, the body appears dark like smoke, with fixed staring and shaking of the head, this indicates the extinction of Heart Qi and is incurable.