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The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "Xunmeng zhaoyou, ming meng er long" (dizziness with visual blurring and head shaking, closed eyes, deafness), which is a condition of excess below and deficiency above, located in the Foot Shaoyang Gallbladder Channel and Foot Jueyin Liver Channel. When severe, the pathogenic factor enters the Liver.

According to Xu Shumi (Xu Xueshi): The so-called "deficiency above" refers to Liver Deficiency. Treating Liver Deficiency addresses dizziness. The sensation of "Xunmeng" feels as if something is covering the head, causing unsteadiness; vertigo and deafness are all manifestations of dizziness. Therefore, for dizziness caused by Liver-Jueyin, the appropriate treatment is Gouteng San (Uncaria Decoction, see formula later).

The *Yuanbing Shi* (Treatise on Original Causes of Diseases) states: "All wind-induced tremors and dizziness belong to Liver Wood," because Wind has the nature of movement. The so-called dizziness and vertigo caused by excessive Wind-Qi occur because Wood Qi is hyperactive, implying that Metal Qi is weak and fails to control Wood, while Wood generates Fire. Both Wind and Fire belong to Yang, and Yang governs movement. When two movements clash, rotation occurs. Thus, Fire inherently moves; when flames encounter wind, they naturally rotate.

Cheng Wuji states: In Shanghan diseases, dizziness is attributed to deficiency. Dizziness upon rising and dizzy spells are all caused after sweating, vomiting, or purging. This indicates Yang Deficiency. Therefore, the *Zhenjing* (Classic of Acupuncture) states: "Deficiency above causes dizziness." However, patients with Wind disorders often experience dizziness because Wind has the nature of movement.

Yan Yonghe states: Although classics state that dizziness mostly results from Liver-Wind attacking upward, individuals with weak constitutions can also experience dizziness due to external contraction of the Six Excesses or internal injury from the Seven Emotions. One must differentiate based on pulse and symptoms. For Wind, the pulse is floating, there is sweating, and stiffness/numbness in the neck. For Cold, the pulse is tight, there is no sweating, and muscle spasms/pain. For Summerheat, the pulse is deficient with irritability. For Dampness, the pulse is fine and heavy, with nausea/vomiting. Regarding injuries from the Seven Emotions, uneven Zang-Qi leads to stagnation, generating phlegm-fluids that congeal into retained fluids. Rising with the Qi, these cause dizziness, pain in the supraorbital ridge, and inability to open the eyes; the Cun pulse is often sunken. This is an exception. Fatigue, lower deficiency with upper excess, traumatic bleeding, epistaxis, bowel/bladder blood loss, menorrhagia, and postpartum blood loss also cause dizziness; treatment should follow the specific cause.

Commentary: The differentiation of Four Qi, Phlegm-Fluids, and Blood Loss conditions described here is insightful, but the collected formulas lack clarity; students should seek them out independently.

Zhang Hezi (Zhang Congzheng) states: Dizziness from Great Wind or Head Wind, along with numbness of hands and feet and epigastric pain, results from the mixture of Wind, Cold, and Dampness forming Bi syndrome. When pathogenic factors reside in the Upper Jiao, it is called Retained Fluids, treatable with Dusheng San (Single Sovereign Powder) to induce vomiting. After vomiting, administer cooling and acrid-clearing herbs for the Upper Jiao.

Commentary: This method is effective and rapid for individuals with robust Qi and Blood who suffer from chronic dizziness due to phlegm-fluid obstruction in the chest and diaphragm.

Careful Analysis: The condition of dizziness is commonly attributed to "Excess Above and Deficiency Below," yet the underlying mechanism is rarely explained. The "Deficiency" refers to Blood and Qi; the "Excess" refers to Phlegm, Saliva, Wind, and Fire. Etiologies include Qi Deficiency, where Clear Yang fails to ascend or excessive sweating leads to Yang collapse; treatment requires raising Yang and tonifying Qi. Blood Deficiency, caused by excessive blood loss leaving Yang without attachment, requires nourishing Yin and tonifying Blood. These are Deficiency patterns. Patterns due to Phlegm-Saliva stagnation require resolving phlegm and guiding stagnation; severe cases may use emesis or purgation. Patterns driven by Wind-Fire require clearing the Upper Jiao and descending Fire. If caused by external pathogens, although Yan differentiated four climatic factors, dispersing pathogens is primary. These are Excess patterns. Some claim "Qi failing to return to its source" and use mineral pills to suppress or Chenxiang (Aquilaria Lignum) to descend Qi. However, Chenxiang is pungent and scatters Qi, while mineral pills assist Fire; thus, displaced Qi cannot be restored this way. The *Neijing* states: "In treating disease, one must seek the root." To address Qi failing to return to its source, one must find the root and medicate accordingly.