经言诸风掉眩。皆属肝木。则眩者风之所作。而肝之所主。河间则责于火。
火炎上而动摇也。丹溪则责于痰。痰流动而冲溢也。然治火并治痰。而眩
如故者何耶。良缘火之有余。本于水之不足。则壮水之主。钱氏六味丸加
鹿茸是也。痰之所发。由于水之上泛。则益火之原。仲景肾气丸补而逐之
是也。使根本坚实。即枝叶扶苏。孰得而震撼之哉。其次则莫如培土。木克
土。而实藉土以自栽。有如思虑太过。则调以归脾。劳役不节。则益以补中。
使心火宁而不盗母气。肺金旺而化源益滋。更入杜仲枸杞山茱萸之属。
上病下取。则鲜有不安者也。盖眩为中之始基。中为眩之究竟。其所以致
此者。未有不戕。贼真阴而得。则又何容讳耶。
一体虚之人。外感六淫。内伤七情。皆能眩晕。当以脉证别之。
一气虚者。乃清气不能上升。或汗多亡阳而致。当升阳补气。血虚者。乃亡
血过多。阳无所附而然。当益阴补血。此皆不足之症也。痰涎郁遏者。宜
开痰导郁。重则吐下。风火所动者。宜清上降火。外感四气。散邪为主。此
皆有余之症也。刘宗浓辨之颇详。要之素无病而忽眩者。当于有余中
求之。素不足而眩者。当于先后天分之。不得以气血该也。
本事川芎散 治肝风眩晕。
山茱萸（一两） 小川芎 人参 山药 茯神 甘菊花（各半两）
为末。每服二钱。酒调下。
钩藤散 治肝火头晕。兼有痰者。
钩藤 陈皮 麦门冬 半夏 茯神 甘菊花 人参 防风 白茯苓（各半两） 甘草（一钱） 石膏（一两）
每服四钱。姜七片。水煎。
许学士二方。用意颇微。不可忽视。
Classical texts state: "All wind diseases causing tremors and dizziness belong to Liver Wood." Therefore, dizziness is caused by Wind pathogen and is governed by the Liver. Liu Hejian attributes it to Fire, as Fire flares upward and causes shaking. Zhu Danxi attributes it to Phlegm, as Phlegm flows and surges. However, if treating Fire and Phlegm does not resolve the dizziness, why is this? The reason lies in that excessive Fire stems from insufficient Water. Thus, one should strengthen the Master of Water (nourish Kidney Yin), such as using Qianyi's Liuwei Wan (Six-Ingredient Pill with Rehmannia) plus Lu Rong (Cervum Cornu). The emergence of Phlegm results from the flooding of Kidney Water; therefore, one should benefit the Source of Fire (warm Kidney Yang), such as using Zhang Zhongjing's Shenqi Wan (Kidney Qi Pill) to tonify and expel. If the root is solid, the branches and leaves will flourish naturally, and who could shake it? Secondly, nothing is better than fortifying Earth (Spleen/Stomach). Although Wood controls Earth, plants actually rely on Earth to take root. For instance, due to excessive mental worry, regulate with Guipi Tang (Restore the Spleen Decoction); due to irregular labor and fatigue, add Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). This calms Heart Fire so it does not steal Qi from its Mother organ, and strengthens Lung Metal so the source of transformation is nourished further. Adding herbs like Duzhong (Eucommiae Cortex), Gouqi (Lycii Fructus), and Shanzhuyu (Corni Fructus), treating upper disorders by targeting the lower, rarely fails to bring peace. Generally, dizziness is the initial basis of Stroke (Zhong Feng), while Stroke is the ultimate outcome of dizziness. The cause of this condition invariably damages True Yin, so there is no need to conceal this fact.
Individuals with a deficient constitution can experience dizziness from external contraction of the Six Excesses (Wind, Cold, Summerheat, Dampness, Dryness, Fire) or internal injury of the Seven Emotions (Joy, Anger, Worry, Pensiveness, Sadness, Fear, Fright). One must distinguish them by pulse and syndrome.
Qi deficiency arises because clear Yang cannot ascend, or results from excessive sweating leading to loss of Yang. Treatment should involve raising Yang and tonifying Qi. Blood deficiency occurs due to excessive blood loss, leaving Yang without attachment. Treatment should involve benefiting Yin and tonifying Blood. These are all Deficient syndromes. When Phlegm-Dampness is stagnant and obstructing, one should resolve Phlegm and guide out stagnation; for severe cases, induce vomiting or purgation. When moved by Wind-Fire, one should clear the Upper Jiao and descend Fire. For external contraction of the Four Seasons' abnormal Qi, dispersing pathogens is primary. These are all Excess syndromes. Liu Zongnong analyzed this in detail. In summary, for those previously healthy who suddenly develop dizziness, seek the cause within Excess patterns; for those chronically deficient who develop dizziness, differentiate between Congenital (Pre-heaven) and Acquired (Post-heaven) deficiencies, rather than merely categorizing under Qi and Blood.
Ben Shi Chuanxiong San (Chuanxiong Powder from Essential Skills): Treats Liver Wind dizziness.
Shanzhuyu (Corni Fructus) (1 liang), Xiaochuanxiong (Rhizoma Chuanxiong), Renshen (Ginseng Radix et Rhizoma), Shanyao (Dioscoreae Rhizoma), Fushen (Poria with Hostwood), Ganjuhua (Chrysanthemi Flos) (each 0.5 liang).
Grind into powder. Take 2 qian per dose, mixed with wine.
Gouteng San (Uncaria Decoction): Treats Liver Fire dizziness accompanied by Phlegm.
Gouteng (Uncariae Ramulus cum Uncis), Chenpi (Citri Reticulatae Pericarpium), Maimendong (Ophiopogonis Tuber), Banxia (Pinelliae Rhizoma), Fushen (Poria with Hostwood), Ganjuhua (Chrysanthemi Flos), Renshen (Ginseng Radix et Rhizoma), Fangfeng (Saposhnikoviae Radix), Bai Fuling (Poria), Gancao (Glycyrrhizae Radix et Rhizoma) (1 qian), Shigao (Gypsum Fibrosum) (1 liang).
Take 4 qian per dose, with 7 slices of fresh ginger, decocted in water.
The two prescriptions by Scholar Xu have subtle intentions and should not be overlooked.