【气虚眩晕之症】气虚即阳虚也。其人面色白，身无热，神识清爽，言语轻微，二便清
利，时或虚阳上浮，头面得火，眩晕不止，或热手按之，则运乃定，此气虚眩晕之症也。
【气虚眩晕之因】大病久病后，汗下太过，元气耗散；或悲号冷引，以伤肺气；曲运神
机，以伤心气；或恼怒伤肝，郁结伤脾，入房伤肾，饥饱伤胃，诸气受伤，则气虚眩晕之症作矣。
中气不足；左寸脉虚，心气不足；左关脉虚，肝胆气弱；两尺脉虚，肾气不足。
【气虚眩晕之治】肺气不足者，人参生脉散，合四君子汤。中气不足者，补中益气汤。
中气虚寒，不能运化水谷者，理中汤。心气不足者，酸枣仁汤。肝气有伤者，逍遥散。肾气不足，
都气丸。真阳不足，虚阳上浮者，肾气丸，加鹿角胶为丸。摄伏降之，古方用一味鹿茸，浓
煎服，治真阳虚者，最效。
人参生脉散 见霍乱。
四君子汤
补中益气汤
理中汤 上三方见痢疾。
酸枣仁汤 见不得卧。
逍遥散 见咳嗽。
都气丸 即六味丸加五味子。
肾气丸 即热八味丸加车前子。
【血虚眩晕之症】血虚即阴虚也，形体黑瘦，五心常热，夜多盗汗，睡卧不宁。头面火
升，则眼花旋转。火气下降，则旋晕亦止，不比外感之常晕不休，不比痰火之暴发暴作，此血
【血虚眩晕之因】阳络伤，则血外溢上逆。阴络伤，则血内溢下泄，凡此亡血成虚，而
为
室，此阴血内耗，血海干枯，而为眩晕者也。
【血虚眩晕之脉】脉多细涩。细而不数，血虚无热；细而带数，血虚有热；左寸细涩，
心血不足；左关细涩，肝不藏血；右关细涩，脾不统血；两尺细数，肾阴枯竭。
【血虚眩晕之治】血从下泄，伤于阴络，血虚无火，脉细不数者，归脾汤、补中益气汤
。
心丹，合安神丸。肝血不足，血虚无火，左关细涩者，逍遥散；血虚有火，左关细数者，知
柏四物汤。脾阴不足，血虚无火，右关细涩者，归脾汤；血虚有火，右关细数者，加味当归
补血汤。肾阴不足，水虚无热，尺脉不数者，八味丸；水虚有火，尺脉洪数者，知柏天地煎
、知柏肝肾丸，古方用玄武胶一味，阴虚火旺最效。
归脾汤 见中风、吐血二门。
补中益气汤 见痢疾。
酸枣仁汤 见不得卧。
天王补心丹 见嗽血。
安神丸 见内伤中风。
逍遥丸 见咳嗽。
知柏四物汤 见喘症。
加味补血汤 即当归补血汤加知母、黄柏。
桢按∶同一失血之症，要分阳络伤而为外溢上逆者，阴络伤而为内溢下泄者。同一血虚
之症，要分血脱阳脱，而为血虚无火，当用归脾汤、补中益气汤，遵血脱益气之法者；又血
脱阳旺，而为血虚有火，用肝肾丸、知柏天地煎、玄武胶，遵壮水之主，以制阳光之法者。
是以凡治虚症而用补剂，当分有火无火，以别或养阳或养阴之大关节也。
[Symptoms of Vertigo due to Qi Deficiency] Qi deficiency is equivalent to Yang deficiency. The patient presents with a pale complexion, no fever in the body, clear consciousness, faint speech, and clear and free urination and defecation. Occasionally, deficient Yang floats upward, causing a sensation of fire in the head and face, with incessant vertigo. Or, when touched by warm hands, the vertigo subsides. This constitutes the symptoms of vertigo due to Qi deficiency.
[Etiology of Vertigo due to Qi Deficiency] After severe or chronic illness, excessive sweating and purging dissipate Yuan Qi (Original Qi); or excessive weeping and exposure to cold damage Lung Qi; overuse of mental effort damages Heart Qi; anger injures the Liver, and emotional stagnation injures the Spleen; sexual indiscretion injures the Kidneys, and irregular eating habits injure the Stomach. When various Qi mechanisms are injured, vertigo due to Qi deficiency arises. Insufficiency of Middle Qi; deficiency of the Left Cun pulse indicates insufficiency of Heart Qi; deficiency of the Left Guan pulse indicates weakness of Liver and Gallbladder Qi; deficiency of both Chi pulses indicates insufficiency of Kidney Qi.
[Treatment of Vertigo due to Qi Deficiency] For insufficiency of Lung Qi, use Rensheng Shengmai San (Ginseng and Pulse-Generating Powder) combined with Sijunzi Tang (Four Gentlemen Decoction). For insufficiency of Middle Qi, use Buzhong Yiqi Tang (Decoction for Reinforcing the Middle and Augmenting Qi). For Middle Qi deficiency with cold, unable to transform and transport food and fluids, use Lizhong Tang (Decoction for Regulating the Middle). For insufficiency of Heart Qi, use Suanzaoren Tang (Zizyphus Seed Decoction). For injury to Liver Qi, use Xiaoyao San (Free and Easy Wanderer Powder). For insufficiency of Kidney Qi, use Duqi Wan (Duqi Pill). For insufficiency of True Yang with floating deficient Yang, use Shenqi Wan (Kidney Qi Pill), compounded with Cornu Cervi Colla (Deer Antler Glue) into pills. To subdue and descend, ancient formulas use single herb Lu Rong (Cervum Nipponis Cornu, Deer Antler), decocted thickly and taken orally, which is most effective for treating True Yang deficiency.
Rensheng Shengmai San: See Cholera section.
Sijunzi Tang: See below.
Buzhong Yiqi Tang: See below.
Lizhong Tang: The above three formulas are seen in the Dysentery section.
Suanzaoren Tang: See Insomnia section.
Xiaoyao San: See Cough section.
Duqi Wan: Consists of Liuwei Wan (Six-Ingredient Pill with Rehmanniae Radix) plus Wuweizi (Schisandrae Fructus).
Shenqi Wan: Consists of Reba Wei Wan (Eight-Ingredient Pill with Rehmanniae Radix Preparata) plus Cheqianzi (Plantaginis Semen).
[Symptoms of Vertigo due to Blood Deficiency] Blood deficiency is equivalent to Yin deficiency. The physique is dark and thin, the "Five Hearts" (both palms, both soles, and the chest) are often hot, night sweats are frequent during sleep, and restlessness occurs during sleep. When fire qi rises to the head and face, visual disturbances and spinning occur. When fire qi descends, the dizziness stops. This differs from external contraction where vertigo is constant, and from Phlegm-Fire where onset is sudden and violent. This describes the symptoms of vertigo due to Blood deficiency.
[Etiology of Vertigo due to Blood Deficiency] Injury to Yang Luo (Yang Collaterals) causes blood to overflow externally and reverse upward. Injury to Yin Luo (Yin Collaterals) causes blood to overflow internally and leak downward. All such cases of blood loss leading to deficiency, and internal consumption of Yin Blood leading to dryness of the Blood Sea, result in vertigo.
[Pulse Signs of Vertigo due to Blood Deficiency] The pulse is mostly fine and choppy. Fine but not rapid indicates Blood deficiency without Heat; fine and rapid indicates Blood deficiency with Heat. Left Cun fine and choppy indicates insufficiency of Heart Blood; Left Guan fine and choppy indicates Liver failing to store Blood; Right Guan fine and choppy indicates Spleen failing to control Blood; both Chi fine and rapid indicate exhaustion of Kidney Yin.
[Treatment of Vertigo due to Blood Deficiency] If blood leaks from below, injuring Yin Luo, resulting in Blood deficiency without Fire, with a fine and non-rapid pulse, use Guipi Tang (Restore the Spleen Decoction) and Buzhong Yiqi Tang. For insufficiency of Heart Qi and depletion of Heart Blood, with Left Cun fine and choppy, use Rensheng Yangrong Tang (Ginseng and Nutritive-Qi-Replenishing Decoction) combined with Tianwang Buxin Dan (Emperor of Heaven's Special Pill for Nourishing the Heart) and Anshen Wan (Calming Spirit Pill). For insufficiency of Liver Blood, Blood deficiency without Fire, with Left Guan fine and choppy, use Xiaoyao San; for Blood deficiency with Fire, with Left Guan fine and rapid, use Zhibo Siwu Tang (Anemarrhena, Phellodendron, and Four Substances Decoction). For insufficiency of Spleen Yin, Blood deficiency without Fire, with Right Guan fine and choppy, use Guipi Tang; for Blood deficiency with Fire, with Right Guan fine and rapid, use Jiawei Danggui Buxue Tang (Modified Danggui Buxue Decoction). For insufficiency of Kidney Yin, Water deficiency without Heat, with non-rapid Chi pulse, use Bawei Wan (Eight-Ingredient Pill); for Water deficiency with Fire, with surging and rapid Chi pulse, use Zhibo Tiandi Jian (Anemarrhena, Phellodendron, Heaven and Earth Decoction) and Zhibo Gan Shen Wan (Anemarrhena, Phellodendron, Liver-Kidney Pill). Ancient formulas use single herb Xuanwu Jiao (Testudinis et Chelonis Carapax et Plastrum, Turtle Shell and Plastrum Glue), which is most effective for Yin deficiency with hyperactive Fire.
Guipi Tang: See Stroke and Hematemesis sections.
Buzhong Yiqi Tang: See Dysentery section.
Suanzaoren Tang: See Insomnia section.
Tianwang Buxin Dan: See Hemoptysis section.
Anshen Wan: See Internal Injury Stroke section.
Xiaoyao Wan: See Cough section.
Zhibo Siwu Tang: See Asthma section.
Jiawei Buxue Tang: Consists of Danggui Buxue Tang (Danggui Tonifying Blood Decoction) plus Zhimu (Anemarrhenae Rhizoma) and Huangbai (Phellodendri Cortex).
Commentary by Zhen: For the same symptom of blood loss, one must distinguish between injury to Yang Luo causing external overflow and upward reversal, versus injury to Yin Luo causing internal overflow and downward leakage. For the same symptom of Blood deficiency, one must distinguish between Blood depletion with Yang depletion, belonging to Blood deficiency without Fire, requiring Guipi Tang and Buzhong Yiqi Tang, following the method of "Augmenting Qi for Blood Depletion"; versus Blood depletion with Yang hyperactivity, belonging to Blood deficiency with Fire, requiring Gan Shen Wan, Zhibo Tiandi Jian, and Xuanwu Jiao, following the method of "Strengthening the Master of Water to Control Solar Flare." Therefore, whenever treating deficiency syndromes using tonifying agents, one must distinguish between presence or absence of Fire, as this is the major principle for differentiating whether to nourish Yang or nourish Yin.