风寒暑湿。气郁生涎。下虚上实。皆晕而眩。其脉风浮寒紧。湿细暑虚。涎弦而滑。虚
脉则无。治眩晕法。尤当审谛。先理痰气。次随症治。
眩者言其黑。晕言其转。冒言其昏。眩晕之与冒眩。其义一也。其状目闭眼眩。身转耳
聋。
如登舟车之上。起则欲倒。盖虚极乘寒得之。亦不可一途而取轨也。风则有汗。寒则掣痛。
暑则热闷。湿则重滞。此四气乘虚而眩晕也。喜怒哀乐。悲恐忧思。郁而生痰。随气上厥
七情致虚而眩晕也。淫欲过度。肾家不能纳气归原。使诸气逆奔而上。此眩晕之出于气虚也
明矣。吐衄崩漏。肝家不能收摄荣气。使诸血失道妄行。此眩晕之生于血虚也又明矣。以至
新产之后。血海虚损。或瘀不行。皆能眩晕。是可不推寻致病之因乎。治法。随机应敌。其
间以升降镇坠行焉。最不可妄施汗下。然而眩晕欲解。自汗则有之。若诸逆发汗。剧者。言
乱目眩。与夫少阴病。下利止而头眩。时时自汗者。此虚极而脱也。识者将有采薪之忧
清晕化痰汤 主方。治眩晕之总司也。
陈皮（去白） 半夏（姜汁炒） 白茯苓（去皮各一钱半） 防风 羌活（各七分） 甘草（三
分） 枳实（麸炒一钱） 川芎 黄芩（酒炒各八分） 白芷 细辛 南星（姜汁炒各七分）
上锉一剂。生姜三片。水煎服。以此作丸。亦可。气虚。加人参七分。白术去芦一钱。
血虚。加当归。倍川芎。有热。加黄连姜炒七分。
一论头旋眼黑。恶心烦闷。气短促上喘。无力言语。心神颠倒。目不敢开。如在风云中
头
若裂。身重如山。四肢厥冷。不得安卧。此乃胃气虚损。停痰而致也。半夏白术天麻汤。（
方见头疼）
一论劳役之人。饥寒眩晕者。脉虚弱也。补中益气汤（方见内伤）根据本方加半夏、天麻
、白芍、熟地黄。
一眩晕属气虚有湿痰者。根据本方去升麻、柴胡。加白茯苓、川芎、半夏、大麻、桔梗、
白芷。
一论阴虚火动眩晕者。脉必数也。清离滋坎汤（方见痨瘵）根据本方加川芎、天麻、山栀、
竹沥少许。
一论真阳不足。上气喘急。气短自汗。眩晕欲倒。如坐舟车。手足冷。脉沉细。
参附汤
人参（五钱） 大附子（炮三钱）
上锉一剂。生姜三片。水煎。热服。
一论眩晕之症。因气虚痰火炎上故也。
清阳除眩汤
人参（六分） 白术（去芦一钱） 白茯苓（一钱） 陈皮（一钱） 半夏（汤泡一钱） 明天
麻（八分） 槟榔（八分） 旋复花（八分） 甘草（四分）
上锉一剂。生姜三片。水煎服。
一论肥白人。日常头旋目花。卒时晕倒者。名曰痰晕。
清痰祛眩汤
天南星（姜泡） 半夏（姜汁制） 天麻 苍术（米泔浸） 川芎 陈皮 茯苓（去皮）
桔梗 枳壳（去穣） 乌药 酒芩 羌活（各八分） 甘草（三分）
上锉一剂。生姜水煎。临服。入竹沥、姜汁同服。
一论虚体之人。一时为寒所中。口不能言。眩晕欲倒。手足厥冷。
姜附汤
干姜（一两） 大附子（生去皮脐一两）
上锉。每五钱。水煎温服。
一论一切失血过多。眩晕不醒者。
芎归汤
川芎 当归（各等分）
上锉一剂。水煎服。虚甚。加炮过大附子。
一论气血两虚而挟寒。作头目眩晕者。十全大补汤（方见补益）根据本方。如有痰。加陈皮
、半夏。
一人气短痰晕。服辛香之剂。痰盛遗尿。两尺浮大。按之如无。予以为肾家不能纳气归
原。香燥致甚耳。用八味丸料。三剂而愈。（八味丸见补益）
一人形体丰浓。劳神喜怒。面带阳色。口渴吐痰。或头目眩晕。或热从腹起。左三脉洪
而有力。予以为足三阴亏损。用补中益气汤加麦门冬、五味。及加减八味丸而愈。
大方痰晕汤
法半夏（一钱） 橘红（一钱） 赤茯苓（一钱） 黄芩（酒洗七分） 白术（一钱五分） 川
芎（五
分） 黄连（五分） 黄柏（酒炒七分） 知母（七分） 石膏（一钱） 薄荷（五分） 甘草（
炙五分）
上锉一剂。生姜三片。水煎。临卧服。
一生圆形体魁梧。不慎酒色。因劳怒头晕仆地。痰涎上涌。手足麻痹。口干引饮。六脉
洪数
而虚。予以为肾经亏损。不能纳气归原而头晕。不能摄水归原而为痰。阳气虚热而麻痹。虚火
上炎
而作渴。补中益气合六味丸料。治之而愈。其后或劳役。或入房。其病即作。用前药而愈。
一孟都宪者。气短痰晕。服辛香之剂。痰盛遗尿。两尺浮大。按之如无。余以为肾家不能纳
气归原。香燥致甚耳。以八味丸料三剂而愈。
一孙都宪形体丰浓。劳神喜怒。面带阳色。口渴吐痰。或头目眩晕。或热从腹起。左三
脉洪而有力。右三脉洪而无力。余谓足三阴亏损。用补中益气加麦门、五味。及加减八味丸而愈
十全大补丸（见补益）
补中益气汤（见内伤）
八味丸
六味丸（俱见补益）
Wind, cold, summer-heat, and dampness (external pathogens of wind, cold, summer-heat, and dampness). Qi stagnation generates phlegm-fluids. Deficiency in the lower jiao and excess in the upper jiao both cause dizziness and vertigo. The pulse presents as floating with wind, tight with cold, fine with dampness, deficient with summer-heat, wiry and slippery with phlegm, and weak or absent with deficiency. In treating vertigo, one must be particularly prudent and thorough. First, regulate the phlegm and Qi; subsequently, treat according to specific symptoms.
"Xuan" (vertigo/dazzlement) refers to blackness before the eyes; "Yun" (dizziness/whirling) refers to a sensation of rotation; "Mao" (giddiness) refers to mental confusion. The meanings of vertigo and giddiness are essentially the same. The manifestations include closed eyes with blurred vision, a sensation of body rotation, deafness, feeling as if on a boat or carriage, and a desire to fall when rising. This is primarily caused by extreme deficiency combined with cold invasion. However, treatment cannot be restricted to a single approach. Wind invasion presents with sweating; cold invasion presents with pulling pain; summer-heat invasion presents with heat and stifling; dampness invasion presents with heaviness and stagnation. These four pathogenic factors cause vertigo when taking advantage of deficiency. Joy, anger, sorrow, happiness, fear, anxiety, and thought (the Seven Emotions), when excessive, lead to Qi stagnation and phlegm generation, which ascends with Qi; this causes vertigo due to deficiency induced by emotional disturbances. Excessive sexual indulgence prevents the Kidney from grasping Qi and returning it to its origin, causing various Qi rebellions to surge upward; this clearly indicates vertigo arising from Qi deficiency. Hematemesis, epistaxis, metrorrhagia, and uterine bleeding prevent the Liver from controlling Ying-Qi, causing blood to flow recklessly out of its normal pathways; this clearly indicates vertigo arising from Blood deficiency. Furthermore, after childbirth, the Sea of Blood is damaged, or blood stasis fails to circulate; all can cause vertigo. Is it not necessary to investigate the causes of disease? Treatment methods should adapt to the situation, employing ascending, descending, sedating, and heavy-settling techniques. It is most inadvisable to indiscriminately use diaphoresis (sweating) or purgation. However, when vertigo is about to resolve, spontaneous sweating may occur. If diaphoresis is incorrectly applied to various rebellious conditions, severe cases may present with confused speech and visual vertigo. Similarly, in Shaoyin disease, if diarrhea stops but head vertigo occurs with frequent spontaneous sweating, this indicates extreme deficiency and collapse. Those with insight will worry about the patient's inability to gather firewood (a metaphor for critical illness/death).
Qingyun Huatan Tang (Clear Dizziness and Resolve Phlegm Decoction) is the principal formula, serving as the general guide for treating vertigo.
Chenpi (Tangerine Peel, white part removed), Banxia (Pinellia Rhizome, stir-fried with ginger juice), Baifuling (Poria, peeled, each 1.5 qian), Fangfeng (Saposhnikovia Root), Qianghuo (Notopterygium Rhizome, each 0.7 qian), Gancao (Licorice Root, 0.3 qian), Zhishi (Immature Bitter Orange, bran-stir-fried, 1 qian), Chuanxiong (Ligusticum Rhizome), Huangqin (Scutellaria Root, wine-stir-fried, each 0.8 qian), Baizhi (Angelica Dahurica Root), Xixin (Asarum Root), Nanting (Arisaema Rhizome, stir-fried with ginger juice, each 0.7 qian).
Crush these into coarse pieces for one dose. Add three slices of fresh ginger, decoct in water, and take orally. This can also be made into pills. For Qi deficiency, add Renshen (Ginseng Root) 0.7 qian and Baizhu (Atractylodes Macrocephala Rhizome, de-gorged) 1 qian. For Blood deficiency, add Danggui (Angelica Sinensis Root) and double the amount of Chuanxiong. For heat, add Huanglian (Coptis Rhizome, ginger-stir-fried) 0.7 qian.
Another discussion: Head spinning, blackening of vision, nausea, restlessness, shortness of breath with wheezing, weakness in speech, mental disorientation, inability to open the eyes, feeling as if the head is splitting in a storm, body heaviness like a mountain, cold limbs, and inability to lie down comfortably. This is caused by Spleen-Stomach Qi deficiency and retained phlegm. Use Banxia Baizhu Tianma Tang (Pinellia, Atractylodes, and Gastrodia Decoction). (Formula see Headache section)
Another discussion: For laborers suffering from vertigo due to hunger and cold, with a weak pulse. Use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (Formula see Internal Injury section), modified by adding Banxia, Tianma, Baishao (White Peony Root), and Shudihuang (Prepared Rehmannia Root).
Another discussion: Vertigo attributed to Qi deficiency with damp-phlegm. Modify the above formula by removing Shengma (Cimicifuga Rhizome) and Chaihu (Bupleurum Root), and add Baifuling, Chuanxiong, Banxia, Tianma, Jiegeng (Platycodon Root), and Baizhi.
Another discussion: Vertigo due to Yin deficiency with hyperactive fire, where the pulse is rapid. Use Qingli Zikan Tang (Clear Li and Nourish Kan Decoction) (Formula see Consumption section), modified by adding Chuanxiong, Tianma, Shanzhi (Gardenia Fruit), and a small amount of Zhuli (Bamboo Sap).
Another discussion: True Yang insufficiency, presenting with asthmatic breathing, shortness of breath, spontaneous sweating, vertigo with a sense of falling, feeling as if on a boat or carriage, cold hands and feet, and a deep, fine pulse. Use Shenfu Tang (Ginseng and Aconite Decoction).
Renshen (Ginseng Root, 5 qian), Dafuzi (Large Aconite Lateral Root, processed, 3 qian).
Crush into coarse pieces for one dose. Add three slices of fresh ginger, decoct in water, and take hot.
Another discussion: Vertigo symptoms caused by Qi deficiency and phlegm-fire flaming upward.
Qingyang Chuexuan Tang (Clear Yang and Eliminate Vertigo Decoction)
Renshen (6 fen), Baizhu (de-gorged, 1 qian), Baifuling (1 qian), Chenpi (1 qian), Banxia (soaked in boiling water, 1 qian), Mingtianma (Gastrodia Rhizome, 0.8 qian), Binglang (Areca Seed, 0.8 qian), Xuanjinhua (Inula Flower, 0.8 qian), Gancao (4 fen).
Crush into coarse pieces for one dose. Add three slices of fresh ginger, decoct in water, and take orally.
Another discussion: In obese, fair-skinned individuals who experience daily dizziness and blurred vision, suddenly fainting is named Tan Yun (Phlegm Vertigo).
Qingtan Quxuan Tang (Clear Phlegm and Remove Vertigo Decoction)
Tian Nanxing (Arisaema Rhizome, ginger-soaked), Banxia (ginger-juice processed), Tianma, Cangzhu (Atractylodes Lancea Rhizome, soaked in rice wash water), Chuanxiong, Chenpi, Fuling (Poria, peeled), Jiegeng, Zhike (Immature Bitter Orange, pulp removed), Wuyao (Lindera Root), Jiu Qin (Wine-washed Scutellaria Root), Qianghuo (each 0.8 qian), Gancao (3 fen).
Crush into coarse pieces for one dose. Decoct with ginger water. Before administration, add Zhuli (Bamboo Sap) and Jiangzhi (Ginger Juice) and mix well.
Another discussion: In constitutionally weak individuals, sudden cold invasion causing muteness, vertigo with a sense of falling, and cold limbs.
Jiangfu Tang (Ginger and Aconite Decoction)
Ganjiang (Dried Ginger, 1 liang), Dafuzi (Large Raw Aconite Lateral Root, peeled and de-navel, 1 liang).
Crush. Take 5 qian per dose, decoct in water, and take warm.
Another discussion: Vertigo and unconsciousness due to excessive blood loss.
Xiong Gui Tang (Ligusticum and Angelica Decoction)
Chuanxiong, Danggui (equal parts).
Crush into coarse pieces for one dose, decoct in water, and take orally. For severe deficiency, add processed Dafuzi (Aconite Lateral Root).
Another discussion: Vertigo of the head and eyes caused by dual deficiency of Qi and Blood complicated by cold. Use Shiquan Dabu Tang (Ten Ingredients Great Tonifying Decoction) (Formula see Tonification section). Modify this formula by adding Chenpi and Banxia if phlegm is present.
Case 1: A patient with shortness of breath and phlegm vertigo took acrid-aromatic agents, resulting in increased phlegm and urinary incontinence. The pulses at both Chi positions were floating and large, but empty upon pressure. I diagnosed this as the Kidney's failure to grasp Qi and return it to its origin, exacerbated by the drying nature of aromatic drugs. Treated with the ingredients of Bawei Wan (Eight-Ingredient Pill) for three doses, resulting in recovery. (Bawei Wan see Tonification section)
Case 2: A patient with a robust physique, mental strain, and emotional fluctuations, presenting with a ruddy complexion, thirst, expectoration, vertigo, or heat rising from the abdomen. The left three pulses were full, forceful, and large. I diagnosed this as deficiency of the Foot Three Yin meridians. Treated with Buzhong Yiqi Tang added with Maidong (Ophiopogon Tuber) and Wuwei Zi (Schisandra Fruit), along with Ji Jian Bawei Wan (Modified Eight-Ingredient Pill), resulting in recovery.
Da Fang Tan Yun Tang (Great Formula for Phlegm Vertigo)
Fabanxia (Processed Pinellia Rhizome, 1 qian), Juhong (Red Tangerine Peel, 1 qian), Chifuling (Red Poria, 1 qian), Huangqin (wine-rinsed, 0.7 qian), Baizhu (1.5 qian), Chuanxiong (0.5 qian), Huanglian (0.5 qian), Huangbai (Phellodendron Bark, wine-stir-fried, 0.7 qian), Zhimu (Anemarrhena Rhizome, 0.7 qian), Shigao (Gypsum Fibrosum, 1 qian), Bohe (Mint Herb, 0.5 qian), Gancao (honey-roasted, 0.5 qian).
Crush into coarse pieces for one dose. Add three slices of fresh ginger, decoct in water, and take before retiring.
Case 3: A tall, sturdy man who neglected caution regarding alcohol and sex, suffered a fall due to dizziness from labor and anger, with surging phlegm-saliva, numbness of limbs, dry mouth with desire to drink. The six pulses were full, rapid, yet empty. I diagnosed this as Kidney Meridian deficiency failing to grasp Qi (causing dizziness) and failing to control water (generating phlegm), with deficient Yang heat causing numbness and deficient fire flaming upward causing thirst. Treated with Buzhong Yiqi Tang combined with Liuwei Wan (Six-Ingredient Pill) ingredients, resulting in recovery. Subsequently, whenever he labored or engaged in sexual activity, the illness recurred, and was cured using the previous prescription.
Case 4: Commissioner Meng suffered from shortness of breath and phlegm vertigo. After taking acrid-aromatic agents, phlegm increased and urinary incontinence occurred. The Chi pulses were floating and large, empty upon pressure. I diagnosed this as the Kidney's failure to grasp Qi and return it to its origin, exacerbated by the drying nature of aromatic drugs. Treated with the ingredients of Bawei Wan for three doses, resulting in recovery.
Case 5: Commissioner Sun had a robust physique, mental strain, and emotional fluctuations, presenting with a ruddy complexion, thirst, expectoration, vertigo, or heat rising from the abdomen. The left three pulses were full and forceful, while the right three pulses were full but weak. I diagnosed this as deficiency of the Foot Three Yin meridians. Treated with Buzhong Yiqi Tang added with Maidong and Wuwei Zi, along with Ji Jian Bawei Wan, resulting in recovery.
Shiquan Dabu Wan (Ten Ingredients Great Tonifying Pill) (see Tonification section)
Buzhong Yiqi Tang (see Internal Injury section)
Bawei Wan (Eight-Ingredient Pill)
Liuwei Wan (Six-Ingredient Pill) (all see Tonification section)