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The symptom of dizziness (Xuanxuan) is mostly caused by phlegm and serves as a precursor to stroke (Zhongfeng). It may be due to cold-phlegm, damp-phlegm, heat-phlegm, or wind-phlegm; it may also result from qi-deficiency with accompanying phlegm, or blood-deficiency with accompanying phlegm. Dizziness caused by cold-phlegm and damp-phlegm may stem from external contraction of cold-dampness or internal injury from raw and cold foods. Dizziness caused by heat-phlegm and wind-phlegm may arise from external contraction of wind-heat or internal agitation of the Seven Emotions (Qingzhi: joy, anger, worry, thought, sadness, fear, fright). Dizziness due to qi-deficiency may result from spleen-deficiency leading to poor appetite, or stomach-weakness causing vomiting and diarrhea. Dizziness due to blood-deficiency often occurs in men due to hematemesis or hematochezia, and in women due metrorrhagia (Bengzhong) or postpartum hemorrhage. Headache and dizziness are merely the branches (symptoms) of the disease; one must treat the root cause for the pain to cease. For instance, postpartum dizziness requires only blood tonification, while spleen-deficiency dizziness requires only qi tonification; this is what is meant by treating the root of the disease. The *Yuan Bing Shi* states: "Tranquility and clarity are the virtue of Water; turmoil and disturbance are the function of Fire." The brain is generated by Earth-Qi and thus stores Yin within the eyes. Kidney-Water, governed by Supreme Yin, shares this preference for tranquility and aversion to disturbance. Tranquility maintains inner clarity, while disturbance causes shaking and scattering, leading to vertigo (naozhuan) and visual dizziness (muxuan). The *Classic* states: "All wind-induced tremors and dizziness belong to Liver-Wood." This condition involves phlegm in the Upper Jiao and fire in the Lower Jiao; the flaming fire agitates the phlegm. "Xuan" refers to darkness/blackness before the eyes, while "Yun" refers to spinning sensation. Although it is said that "no phlegm, no dizziness," the root lies in qi and blood deficiency, which allows phlegm-fire to arise. Wind enters the brain, assisting phlegm-fire to induce dizziness, truly resulting from excess above and deficiency below. The "deficiency below" refers to deficient blood and qi; the "excess above" refers to floating phlegm-fire. In acute cases, treat phlegm-fire; in chronic cases, tonify Yuan Qi. Furthermore, stagnation of the Seven Emotions generates phlegm, which moves with fire and ascends with Qi, causing dizziness due to emotional-induced deficiency. Excessive sexual activity prevents the Kidneys from grasping Qi and returning it to its origin, causing all Qi to rush upward, leading to dizziness due to qi-deficiency. Hematemesis, epistaxis, and metrorrhagia indicate the Liver's failure to control Ying-Qi, causing blood to flow recklessly out of its channels, leading to dizziness due to blood-deficiency. By carefully examining pulse signs and distinguishing the etiology, and treating the root according to the etiology, the disease will surely be cured. In summary, it is like a tree with an unstable root, causing branches and leaves to shake; even without external touch, it is due to dual deficiency of qi and blood, with turbid phlegm failing to descend.

For severe, unbearable dizziness, use Rhubarb (Dahuang) stir-fried with wine, ground into powder, and taken with tea water; this treats conditions of excessive phlegm-fire. There was once a woman who suffered from red-and-white leukorrhea for over a year, experiencing such severe dizziness that she could not sit or stand, finding relief only when sleeping. Treating the leukorrhea specifically cured the discharge, and subsequently, the dizziness resolved; this illustrates treating qi and blood insufficiency through syndrome differentiation. If the head and face prefer warmth and pressure alleviates dizziness, this indicates Yang-deficiency, requiring Yang tonification. If the face is red and ears feel hot, with dizziness worsening under stress, this indicates Yin-deficiency, requiring Yin nourishment.