经曰∶诸风掉眩，皆属肝木。夫眩运之始，必因火克肺金，金衰不能制木，故木旺而生风。
肝木既旺，复能生火。风火二气属阳，阳主动，性同上升，两动相搏，则为旋转，犹焰得风。然
而未有不兼四气七情者。七情相感，脏气不平，郁而生涎，积而为饮，煎熬成痰，火动其痰，令
人眩运。又挟于疲劳过度，血液耗损，精髓亏伤，皆能致此。发则头运目眩，耳鸣身转，昏愦欲
倒，如立舟车，乃上实下虚也。脉浮有汗属风；脉紧无汗属寒；脉虚烦闷属暑；脉沉吐逆属湿。
左关弦数肝火，右寸滑大多痰。治痰为主，降火驱风，补养血气。
主方 天麻（明实） 荆芥穗 橘红 半夏（各二钱） 茯苓（钱半） 枳实 川芎（各
一钱） 酒芩 羌活 防风 南星（各七分） 甘草（三分）加生姜三片，水煎，入竹沥、姜汁
服。
火盛加黄连（酒炒）、栀子；肥人及病后气虚，加人参、白术，去枳实；瘦人血虚有火及妇
人产后，当归、熟地，去南星；风热上攻，防风通圣散。
滋补正元汤 治气血两虚，心脾耗损，神昏，有痰眩运，一服安。
当归 黄 白术（各钱半） 白芍（酒炒） 茯苓 茯神 生地 麦冬（一钱） 人参
远志 陈皮 半夏 川芎（各七分） 炙草（五分）
上加生姜三片、黑枣一枚，水煎，早晚服。
运倒肢冷虚极∶人参（五钱）、附子（三钱），加姜煎。劳苦人眩，补中益气汤（见虚损）。
眩运甚者火极∶大黄（酒煮，炒干研末，三钱），茶下。有痰人眩，半术天麻汤（见头痛）。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "All wind diseases involving tremors and vertigo belong to Liver Wood." The onset of vertigo (dizziness/vertigo) is invariably caused by Fire overcoming Lung Metal, leading to the decline of Lung Qi which fails to control Liver Wood, thereby causing Liver Wood to flourish and generate internal Wind.
Once Liver Wood flourishes, it generates Fire. Both Wind and Fire are Yang pathogens; Yang governs movement and tends to ascend. When these two dynamic forces clash, a sensation of rotation occurs, similar to flames fanned by the wind. However, this condition rarely occurs without being complicated by the Four Climatic Factors (wind, cold, summer-heat, dampness) or the Seven Emotions (joy, anger, worry, thought, grief, fear, fright). The interaction of the Seven Emotions causes disharmony in Zang-Fu Qi, leading to stagnation that produces phlegm-fluids (Xian), which accumulate into fluid retention (Yin), and are then boiled down into Phlegm (Tan). When Fire stirs this Phlegm, it induces vertigo. Furthermore, excessive fatigue, depletion of Blood, and deficiency of Essence can all lead to this condition. Upon attack, patients experience dizziness, blurred vision, tinnitus, bodily rotation, confusion, and a sensation of fainting, as if standing on a moving boat or carriage. This represents an Excess at the Upper Jiao and Deficiency at the Lower Jiao. A floating pulse with sweating indicates Wind; a tight pulse without sweating indicates Cold; a deficient pulse with irritability indicates Summer-Heat; a deep pulse with vomiting and reflux indicates Dampness. A wiry and rapid pulse at the left Guan position indicates Liver Fire; a slippery and large pulse at the right Cun position indicates abundant Phlegm. Treatment focuses primarily on resolving Phlegm, accompanied by descending Fire, expelling Wind, and tonifying Blood and Qi.
Main Formula: Tianma (Gastrodiae Rhizoma, selecting solid specimens), Jingjie Sui (Schizonepetae Spica), Juhong (Exocarpium Citri Reticulatae Chanhong), Banxia (Pinelliae Rhizoma Preparatum) [each 2 qian]; Fuling (Poria) [1.5 qian]; Zhishi (Aurantii Fructus Immaturus); Chuanxiong (Ligustici Chuanxiong Rhizoma) [each 1 qian]; Jiuhuangqin (Scutellariae Radix prepared with wine); Qianghuo (Notopterygii Rhizoma et Radix); Fangfeng (Saposhnikoviae Radix); Nanting (Arisaematis Cum Bile Rhizoma) [each 7 fen]; Gancao (Glycyrrhizae Radix et Rhizoma) [3 fen]. Add three slices of Shengjiang (Zingiberis Rhizoma Recens), decoct in water, and administer with Zhuli (Bambusae Caulis in Taenia) and Jiangzhi (Zingiberis Succus).
If Fire is excessive, add Huanglian (Coptidis Rhizoma prepared with wine) and Zhizi (Gardeniae Fructus); for obese individuals or those with Qi deficiency after illness, add Renshen (Ginseng Radix et Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma), and remove Zhishi; for emaciated individuals with Blood deficiency and Fire, or postpartum women, add Danggui (Angelicae Sinensis Radix) and Shudihuang (Rehmanniae Radix Preparata), and remove Nanting; for attacking Wind-Heat, use Fangfeng Tongsheng San.
Zibu Zhengyuan Tang: Treats dual deficiency of Qi and Blood, consumption of Heart and Spleen, mental confusion, and Phlegm-induced vertigo; one dose brings relief.
Prescription: Danggui (Angelicae Sinensis Radix), Huangqi (Astragali Radix), Baizhu (Atractylodis Macrocephalae Rhizoma) [each 1.5 qian]; Baishao (Paeoniae Radix Alba prepared with wine); Fuling (Poria); Fushen (Poria with Hostwood); Shengdi Huang (Rehmanniae Radix); Maidong (Ophiopogonis Radix) [each 1 qian]; Renshen (Ginseng Radix et Rhizoma); Yuanzhi (Polygalae Radix); Chenpi (Citri Reticulatae Pericarpium); Banxia (Pinelliae Rhizoma Preparatum); Chuanxiong (Ligustici Chuanxiong Rhizoma) [each 7 fen]; Zhigancao (Glycyrrhizae Radix et Rhizoma preparata) [5 fen].
Add three slices of Shengjiang (Zingiberis Rhizoma Recens) and one black date (Jujubae Fructus), decoct in water, and take morning and evening.
For severe vertigo with cold limbs indicating extreme deficiency: Use Renshen (Ginseng Radix et Rhizoma) [5 qian] and Fuzi (Aconiti Lateralis Radix Preparata) [3 qian], decoct with ginger. For laborers suffering from vertigo, use Buzhong Yiqi Tang (see Chapter on Deficiency Damage).
For severe vertigo due to extreme Fire: Use Dahuang (Rhei Radix et Rhizoma) [boiled in wine, dried, ground to powder, 3 qian], taken with tea. For patients with Phlegm suffering from vertigo, use Banshu Tianma Tang (see Chapter on Headache).