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Phlegm-fluid retention (Tan Yin), wind-headache (Tou Feng), seven qi disorders (Qi Qi), blood loss, and alcohol intoxication can all cause vertigo. These conditions have been discussed in their respective syndrome chapters. Here, we specifically address cases of vertigo occurring without accompanying other diseases, which are all attributed to deficiency and damage (Xu Sun).

Some patients experience intermittent vertigo; others suffer from vertigo upon rising in the morning, which subsides after a short while and becomes a daily routine. For such cases, Zhengyuan Yin (Upright Origin Decoction) should be administered, followed by Heixi Dan (Black Tin Pill).

For dizziness caused by dampness invasion, Shenzhuo Tang (Kidney-Dampness Decoction) with added Chuanxiong Rhizome (Chuanxiong) is named Chushi Tang (Dampness-Removing Decoction).

In cases where vertigo results from deficiency, even after the vertigo subsides, the patient's face often desires proximity to fire, and they wish for warm hands to press upon the head. This is because the head and face are the confluence of all yang meridians, and insufficient yang qi is the cause.

Patients with wind-headache syndrome may experience constant tinnitus and a buzzing sound in the head, like birds chirping. One must not assume that tinnitus is solely due to deficiency; this is caused by wind pathogen affecting the head and brain.

In severe cases of vertigo, looking up causes the sensation of the room spinning, dark spots frequently appear before the eyes, objects seem to fly or move, or diplopia (double vision) occurs. Xiaosanwuqi San (Minor Three-Five-Seven Powder), Xiongfu Tang (Ligusticum and Aconite Decoction), or Shengliao Zhengyuan Yin (Unprocessed Zhengyuan Decoction) with one qian of Deer Antler (Lurong) are suitable, followed by Lingsha Dan (Cinnabar and Mercury Pill). Alternatively, Zhengyuan Yin with fifteen grains of fried Sichuan peppercorn (Chuanjiao) may be used, followed by Rongzhu Wan (Antler and Cinnabar Pill). If ineffective, use only Deer Antler (Lurong), half liang per dose, decocted in three cups of unadulterated wine until reduced to one cup. Strain and add a small amount of Moschus (Shexiang). Since deer antler grows on the head, using it for vertigo follows the principle of "similar things attract." There was a case of persistent headache cured by Rongzhu Dan.

When deficient fire flares upward, causing failure of yin and yang to ascend and descend properly, with lower deficiency and upper excess, leading to rapid breathing and acute asthma, Suzi Jiangqi Tang (Perilla Seed Descending Qi Decoction) without Qianhu, followed by Heixi Dan or Yangzheng Dan, is indicated.

If asthma is severe enough to prevent lying down and sleeping, Chenfu Tang or Zhengyuan Yin may be used. Alternatively, Sigui Tang without Muxiang but with Chenxiang, boiled with salt, followed by Heixi Dan, Lingsha Dan, or Sanmiao Dan. If ineffective, administer Zhusha Dan with the aforementioned decoctions.

For shortness of breath and fatigue, where lower qi fails to connect with upper qi, breathing is difficult, and speech is weak, Buxu Sigui Yin (Deficiency-Nourishing Four-Ginger Decoction) with half the dosage of Muxiang and one qian each of Huangqi and Dioscorea Rhizome (Shanyao) is suitable.

For those who cannot tolerate hot medicines or have excessive phlegm, prepared Aconite Root (Fuzi) should be replaced with raw Aconite Root. This requires clinical flexibility; other formulas follow this pattern. If the medication is too mild for the severity of the disease, Sigui Yin may be insufficient. In such cases, remove Muxiang from the base formula and add fifteen fried Sichuan peppercorns (Chuanjiao). If still ineffective, use Jiaofu Tang (Peppercorn and Aconite Decoction). For patients with upper jiao dryness who cannot tolerate hot medicines, add one qian of Ginseng Radix et Rhizoma (Renshen) to Jiaofu Tang. While ginger and aconite are typically used, if upper jiao dryness-heat precludes their use, this formula is most effective.

For individuals with shortness of breath and fatigue, besides administering medicine, select a robust male to inhale his own breath and exhale it into the patient's mouth several times. This can assist the medicinal effect. This method is not only effective for deficiency and fatigue but also highly efficacious for hiccups caused by sudden rebellious qi.