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Vertigo is defined as the sensation of dimness in vision, darkness, and spinning or falling. Its manifestations include dizziness with closed eyes, a sensation of body rotation, tinnitus, and deafness, resembling the feeling of standing on a moving boat or carriage, accompanied by palpitations and an inability to remain calm. The *Classic of Internal Medicine* states: "All wind-induced tremors and vertigo belong to the Liver." It also states: "When the sea of marrow is insufficient, there will be spinning of the head, tinnitus, soreness of the shins, and dizzy confusion." Therefore, Chen Xiuyuan (Zhongchun) attributes vertigo to a deficiency of Liver Blood combined with a deficiency of Kidney Water. Zhu Danxi stated: "Without phlegm, there is no vertigo." Phlegm resides in the upper jiao, while fire resides in the lower jiao; when fire flares upward and disturbs the phlegm, vertigo occurs. However, the causes of vertigo are not singular. There are cases caused by external contraction of the Six Evils (Liu Yin), which should be treated according to their respective disease categories. If caused by blood deficiency and yin deficiency, tonify the Liver and Kidneys; if caused by flaming fire and moving phlegm, treat the phlegm and fire. For vertigo due to Qi deficiency, formulas such as Yigong San (Efficacious Powder) and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) are appropriate. For vertigo due to excessive blood loss (whether from the upper or lower orifices), select formulas such as Baoyin Jian (Preserve the Yin Decoction), Jiling Gao (Ji Ling Paste), and Guipi Tang (Restore the Spleen Decoction). In cases where Kidney Yang is declining and turbid Yin rebels upward causing vertigo, this is a critical condition requiring urgent treatment with Ren Shen (Ginseng Radix et Rhizoma), Chen Xiang (Aquilaria Lignum), Sha Ren (Amomi Fructus), and Bawei Wan (Eight-Ingredient Pill) to direct Yang Qi back to its source. Postpartum vertigo with loss of consciousness is called Blood Vertigo (Xue Yun), which is also a critical condition; its treatment is discussed in the chapter on Blood Vertigo. Generally, individuals who are fat and pale and suffer from vertigo are mostly suitable for treatments that resolve phlegm and descend fire, possibly combined with Qi-tonifying herbs; those who are dark-skinned and thin and suffer from vertigo are suitable for treatments that nourish Yin and tonify the Kidney, combined with Liver-nourishing agents. This is the general principle for treating vertigo.

Xiaoyao San (Free and Easy Wanderer Powder) [See Xu Lao].
It is advisable to add Gan Ju (Chrysanthemi Flos) and Gou Teng (Uncariae Ramulus cum Uncis). [These are essential herbs for calming the Liver and descending vertigo, generally usable.] For Liver Blood deficiency, add Zao Ren (Ziziphi Spinosae Semen) and Gou Qi Zi (Lycii Fructus); for severe Liver Fire, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) plus Ling Yang Jiao (Capricornu Coris Cornu) and Tian Ma (Gastrodiae Rhizoma).
These are key herbs for the Liver Meridian. Since various wind-induced tremors and vertigo belong to the Liver, these modifications are generally used for treatment.

Liujun Wan (Six-Ingredient Rehmannia Pill) and Zuogui Yin (Left Restoring Decoction) [Both see Xu Lao].
It is advisable to add Gan Ju (Chrysanthemi Flos), Gou Teng (Uncariae Ramulus cum Uncis), and Bai Shao (Paeoniae Radix Alba). [Danxi stated: Among herbs for treating vertigo, it is advisable to add herbs that restrain the Liver as assistants. Although Ju and Teng are said to calm Wood, and Bai Shao is said to restrain the Liver, none of them are harshly draining.] Zao Ren (Ziziphi Spinosae Semen) [Tonifies the Liver and nourishes Yin]. Niu Xi (Achyranthis Bidentatae Radix) [Benefits essence and fills marrow].
These two formulas are generally applicable for vertigo attributed to Kidney Water deficiency.

Baoyin Jian (Preserve the Yin Decoction), Jiling Gao (Ji Ling Paste), and Guipi Tang (Restore the Spleen Decoction) [All see Xu Lao].
These three formulas are suitable for vertigo attributed to Blood deficiency and should be selected accordingly. For excessive hematemesis or epistaxis with Lung heat and phlegm cough, Baoyin Jian added with Gan Ju (Chrysanthemi Flos), Gou Teng (Uncariae Ramulus cum Uncis), Bai Shao (Paeoniae Radix Alba), and Zao Ren (Ziziphi Spinosae Semen) is appropriate. Without Lung heat, Jiling Gao (Ji Ling Paste) with these additions can be used. For metrorrhagia, melena, or excessive postpartum hemorrhage, Guipi Tang (Restore the Spleen Decoction) added with Gan Ju (Chrysanthemi Flos), Gou Teng (Uncariae Ramulus cum Uncis), Di Huang (Rehmanniae Radix), Bai Shao (Paeoniae Radix Alba), and Tian Dong (Asparagi Radix) is suitable. In cases where these are not indicated, formulas like Baoyin Jian (Preserve the Yin Decoction) should still be used.

Yigong San (Efficacious Powder) [See Feng Zhong] and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) [See Xie Xie].
These two formulas are applicable for vertigo attributed to Qi deficiency.

Erchen Tang (Two-Aged Decoction) [See Feng Zhong].
It is advisable to add Tian Ma (Gastrodiae Rhizoma), Zhi Ke (Aurantii Fructus Immaturus), Xiang Fu (Cyperi Rhizoma), and Sha Ren (Amomi Fructus). If complicated by Fire, add Huang Qin (Scutellariae Radix) and Huang Lian (Coptidis Rhizoma); if complicated by deficiency, add Ren Shen (Ginseng Radix et Rhizoma) and Bai Zhu (Atractylodis Macrocephalae Rhizoma).
This is a formula for treating vertigo due to damp-phlegm and jue-ni (reversal cold/vertigo).