头眩，痰，挟气虚并火。治痰为主，挟补
药及降火药。无痰则不作眩，痰因火动。又有湿痰者，有火痰者。湿痰者，多宜二陈汤。
火者，加酒芩。挟气虚者，相火也，治痰为先，挟气药降火，如东垣半夏白术天麻汤之类
不可当者，以大黄酒炒为末，茶汤调下，火动其痰，用二陈加黄芩、苍术、羌活，散风行湿
。左手脉数热多，脉涩有死血；右手脉实有痰积，脉大是久病（久一作虚）。久病之人，气血
俱虚而脉大，痰浊不降也。昔有一老妇，患赤白带一年半，头眩，坐立不得，睡之则安。专
治赤白带，带愈，其眩亦安。
〔附录〕眩者，言其黑晕转旋，其状目闭眼暗，身转耳聋，如立舟船之上，起则欲倒。盖
虚极乘寒得之，亦不可一途而取轨也。又风则有汗，寒则掣痛，暑则热闷，湿则重滞，此四
乘虚而眩晕也，又或七情郁而生痰动火，随气上厥，此七情致虚而眩运也。淫欲过度，肾
不能纳气归元，使诸气逆奔而上，此气虚眩运也；吐衄漏崩，肝家不能收摄荣气，使诸血失道
妄行，此血虚眩运也。要寻致病之因，随机应敌。其间以升降镇坠行汗为最，不可妄施汗
下。识者将有采薪之忧。有早起眩运，须臾自定，日以为常者，正元饮下黑锡丹。伤湿
头运，肾着汤加川芎，名除湿汤。疏风，川芎茶调散；有痰，青州白丸子。
附方
头晕方 利痰，清热，降火，或滚痰丸亦可。
南星（五分，制） 半夏（一钱） 桔梗（七分） 枳壳（一钱） 陈皮（一钱） 甘草（五分） 茯苓（一钱） 黄
芩（七分）
上作一服，生姜七片，水煎，食后服。
香橘饮 治气虚眩晕。
木香 白术 半夏曲 橘皮 茯苓 砂仁（各半两） 丁香 甘草（炙，二钱半）
上锉散。水二盏，生姜五片，煎服。加当归、川芎、
白附子丸 治风痰上厥，眩晕头疼。
全蝎（半两，炒） 白附子（炮） 南星（炮） 半夏 旋复花 甘菊 天麻 川芎 橘红 僵
蚕（炒） 干姜（生，各二两）
上为末，生姜半斤取汁，打糊丸梧子大。煎荆芥汤下五十丸。
人参前胡汤 治风痰头晕目眩。
半夏曲 木香 枳壳（炒） 紫苏 赤茯苓 南星（炮） 甘草（炙，各五钱） 人参（三钱） 前
胡（五钱） 橘红（五钱）
上锉散。每服五钱，生姜五片，水煎服。
芎术除眩散 治感湿感寒，头重眩晕。
附子（生） 白术 川芎（各半两） 官桂 甘草（炙，各二钱半）
上锉。每服三钱，姜七片，水煎服。
茯苓桂枝白术甘草汤 治气上冲胸，战摇眩晕。
茯苓（一两） 桂枝（七钱半）白术 甘草（炙，各半两）
上锉。每服四钱，水煎服。风症，加川芎、细辛；湿症，
加川芎、苍术；寒症，加干姜、良姜。
半夏白术天麻汤 见头痛类。
正元散
红豆（炒，三钱） 人参（二两） 肉桂（半两） 附子（炮，去皮尖） 川芎 山药（姜汁炒） 乌药
（各一两） 川乌（炮，去皮脐，半两） 干姜（炮，三钱） 白术 甘草（炙） 茯苓（各二两） 陈皮（二
钱） 黄 （炙，一两半）
上 咀。每服三钱，水一盏，姜三片，枣一个，入盐
黑锡丹
肉桂（半两） 沉香 附子（炮，去皮脐） 故纸 胡芦巴（酒浸炒） 茴香（炒） 肉豆蔻（面
裹煨） 阳起石（研细水飞） 金铃子（蒸去皮核） 木香（各一两） 硫黄 黑锡（去滓，各二两）
上用黑盏或新铁铫内，如常法，结黑锡、硫黄、砂子，地上出火毒，研令极细，余药并
，罗为末，一处和匀，自朝至暮，以研至黑光色为度，酒糊丸如桐子大，阴干，入布袋内，
擦令光莹。每服四十粒，空心盐姜汤或枣汤下；女人艾枣汤下。
肾着汤 见腰痛类。
川芎茶调散 见头痛类。
头眩（头晕目眩），多由痰浊、气虚和火邪共同引起。治疗以化痰为主，配合补益药及降火药。没有痰就不会发生眩晕，因为痰是因火邪扰动而动的。又有湿痰和火痰之分。湿痰者，多适宜使用二陈汤；火痰者，在方中加入酒制黄芩。兼有气虚者，属于相火妄动，治疗先以化痰为先，配合补气药和降火药，如李东垣的半夏白术天麻汤之类。如果症状严重难以忍受，可用生大黄经酒炒后研成粉末，用茶汤调服。火邪扰动痰浊，可用二陈汤加黄芩、苍术、羌活，以疏散风邪、祛除湿气。左手脉数表示热盛，脉涩表示有瘀血；右手脉实表示有痰积，脉大表示久病（“久”一作“虚”）。久病之人，气血都虚弱却出现脉大，这是痰浊不能下降所致。过去有一位老妇人，患赤白带下一年半，伴有头晕目眩，坐立不安，睡觉时则安宁。专门治疗赤白带下，带下病痊愈后，眩晕也随之安定。
〔附录〕眩晕，是指眼前发黑、旋转的感觉，其症状表现为闭眼昏暗，身体旋转，耳聋，如同站在船船上一样，起身时想要跌倒。这大多是极度虚弱又感受寒邪所致，也不能仅凭一种途径来确立治疗方案。另外，受风则有汗，受寒则牵引疼痛，受暑则烦热闷乱，受湿则沉重滞涩，这四种情况乘人体虚弱而导致眩晕；或者因七情郁结而生痰动火，随气上逆，这是七情导致虚损而引起的眩晕；房事过度，肾不能纳气归元，使各种气逆奔而上冲，这是气虚引起的眩晕；吐血、衄血、漏下、崩中，肝不能收摄营气，使各种血液失道妄行，这是血虚引起的眩晕。必须寻找致病的病因，随机应变。其中升降、镇坠、行汗最为关键，不可妄用发汗或攻下法。明理的人将会避免由此带来的忧患（指病情加重或误治）。如果有早起眩晕，片刻后自行缓解，每天如此的情况，可服用正元饮送服黑锡丹。伤湿导致的头晕，可用肾着汤加川芎，名为除湿汤。疏风，用川芎茶调散；有痰，用青州白丸子。
附方
头晕方：利痰，清热，降火，也可用滚痰丸。
南星（五分，制） 半夏（一钱） 桔梗（七分） 枳壳（一钱） 陈皮（一钱） 甘草（五分） 茯苓（一钱） 黄芩（七分）
以上为一剂，生姜七片，水煎，饭后服用。
香橘饮：治疗气虚眩晕。
木香 白术 半夏曲 橘皮 茯苓 砂仁（各半两） 丁香 甘草（炙，二钱半）
以上锉散。水两盏，生姜五片，煎服。加当归、川芎。
白附子丸：治疗风痰上逆，眩晕头痛。
全蝎（半两，炒） 白附子（炮） 南星（炮） 半夏 旋复花 甘菊 天麻 川芎 橘红 僵蚕（炒） 干姜（生，各二两）
以上研为粉末，取生姜半斤榨汁，打糊制成梧桐子大小的丸药。用荆芥汤送服五十丸。
人参前胡汤：治疗风痰头晕目眩。
半夏曲 木香 枳壳（炒） 紫苏 赤茯苓 南星（炮） 甘草（炙，各五钱） 人参（三钱） 前胡（五钱） 橘红（五钱）
以上锉散。每服五钱，生姜五片，水煎服。
芎术除眩散：治疗感湿感寒，头重眩晕。
附子（生） 白术 川芎（各半两） 官桂 甘草（炙，各二钱半）
以上锉。每服三钱，姜七片，水煎服。
茯苓桂枝白术甘草汤：治疗气上冲胸，战摇眩晕。
茯苓（一两） 桂枝（七钱半） 白术 甘草（炙，各半两）
以上锉。每服四钱，水煎服。风症，加川芎、细辛；湿症，加川芎、苍术；寒症，加干姜、良姜。
正元散
红豆（炒，三钱） 人参（二两） 肉桂（半两） 附子（炮，去皮尖） 川芎 山药（姜汁炒） 乌药（各一两） 川乌（炮，去皮脐，半两） 干姜（炮，三钱） 白术 甘草（炙） 茯苓（各二两） 陈皮（二钱） 黄芪（炙，一两半）
以上切碎。每服三钱，水一盏，姜三片，枣一个，入盐少许。
黑锡丹
肉桂（半两） 沉香 附子（炮，去皮脐） 故纸（补骨脂） 胡芦巴（酒浸炒） 茴香（炒） 肉豆蔻（面裹煨） 阳起石（研细水飞） 金铃子（蒸去皮核） 木香（各一两） 硫黄 黑锡（去滓，各二两）
以上用黑釉碗或新铁锅，按常规方法，炼制黑锡、硫黄、砂子，在地上消除火毒，研磨至极细，其余药物也粉碎过筛，混合均匀，从早到晚，研磨至黑色光亮为止，用酒糊制成梧桐子大小的丸药，阴干，装入布袋内，擦拭使其光莹。每服四十粒，空腹用盐姜汤或枣汤送服；女性用艾叶枣汤送服。
Dizziness (Xuantuan), is primarily caused by phlegm, qi deficiency, and fire. Treatment focuses on resolving phlegm, combined with tonifying herbs and herbs that descend fire. Without phlegm, dizziness does not occur; phlegm moves due to the agitation of fire. There are also distinctions between damp-phlegm and fire-phlegm. For damp-phlegm, Er Chen Tang (Two-Aged Decoction) is mostly suitable. For fire-phlegm, add wine-processed Huangqin (Scutellariae Radix) to the formula. When accompanied by qi deficiency, it involves ministerial fire (Xianghuo); treatment prioritizes resolving phlegm, combined with qi-tonifying herbs and herbs that descend fire, such as Banxia Baizhu Tianma Tang (Pinellia, Atractylodes Macrocephala, and Gastrodia Decoction) from Li Dongyuan. If symptoms are severe and unbearable, raw Dahuang (Rhei Radix et Rhizoma), processed with wine and ground into powder, can be taken mixed with tea water. When fire agitates phlegm, Er Chen Tang can be modified with Huangqin (Scutellariae Radix), Cangzhu (Atractylodis Rhizoma), and Qianghuo (Notopterygii Rhizoma et Radix) to disperse wind and eliminate dampness. A rapid pulse at the left position indicates excessive heat; a choppy pulse indicates static blood. A full pulse at the right position indicates phlegm accumulation; a large pulse indicates chronic illness ("chronic" may alternatively read as "deficiency"). In patients with chronic illness, if both qi and blood are deficient yet the pulse is large, it signifies that turbid phlegm fails to descend. In the past, an elderly woman suffered from red and white leukorrhea for a year and a half, accompanied by dizziness, making sitting or standing uncomfortable, but finding relief when sleeping. By specifically treating the leukorrhea, once the discharge ceased, the dizziness also resolved.
[Appendix] Dizziness refers to the sensation of blackness and rotation in vision. Its manifestations include closed eyes with dim vision, body spinning, deafness, and a feeling akin to standing on a rocking boat, with a tendency to fall upon rising. This condition often arises from extreme deficiency compounded by cold pathogen invasion, and cannot be treated by a single method alone. Furthermore, wind invasion causes sweating; cold invasion causes pulling pain; summerheat invasion causes feverish stifling; dampness invasion causes heaviness and stagnation. These four pathogens cause dizziness when taking advantage of deficiency. Alternatively, emotional depression (Seven Emotions) generates phlegm and stirs fire, which ascends with qi, causing dizziness due to deficiency induced by emotions. Excessive sexual activity prevents the Kidney from grasping qi and returning it to its source, causing various qi to rush upward, leading to dizziness due to qi deficiency. Hematemesis, epistaxis, metrorrhagia, and metrostaxis indicate that the Liver fails to secure Ying-nutritive qi, causing blood to flow recklessly out of its channels, leading to dizziness due to blood deficiency. One must identify the cause of the disease and respond flexibly. Among treatments, those involving ascending/descending, sedating/heavy-settling, and diaphoresis are most critical; one must not rashly use diaphoretic or purgative methods. Those who understand this will avoid the worry of being unable to gather firewood (a metaphor for severe debility or mismanagement). For cases of morning dizziness that resolves spontaneously after a short while and becomes a daily routine, Zhengyuan Yin (Upright Qi Decoction) can be taken with Heixi Dan (Black Tin Pill). For dizziness due to dampness injury, Shen Zhuo Tang (Kidney-Dampness Decoction) with Chuanxiong (Ligustici Chuanxiong Rhizoma), named Chushi Tang (Dampness-Expelling Decoction), is used. For wind dispersal, Chuanxiong Chatiao San (Ligusticum Tea-Powdering Powder) is used; for phlegm, Qingzhou Baiwanzi (Qingzhou White Pill) is used.
Attached Formulas
Touyun Fang (Head Dizziness Formula): Resolves phlegm, clears heat, descends fire; Guntan Wan (Rolling Phlegm Pill) may also be used.
Nanxing (Arisaematis Rhizoma, 5 fen, processed), Banxia (Pinelliae Rhizoma, 1 qian), Jiegeng (Platycodonis Radix, 7 fen), Zhike (Aurantii Fructus, 1 qian), Chenpi (Citri Reticulatae Pericarpium, 1 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 5 fen), Fuling (Poria, 1 qian), Huangqin (Scutellariae Radix, 7 fen).
Take as one dose, with seven slices of Shengjiang (Zingiberis Rhizoma Recens), decoct in water, and take after meals.
Xiangju Yin (Fragrant Orange Decoction): Treats dizziness due to qi deficiency.
Muxiang (Aucklandiae Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Banxiaqu (Pinelliae Fermentatum), Ju pi (Citri Reticulatae Pericarpium), Fuling (Poria), Sharen (Amomi Fructus Rotundus) (each 0.5 liang), Dingxiang (Caryophylli Flos), Gancao (Glycyrrhizae Radix et Rhizoma, roasted, 2.5 qian).
Grind into coarse powder. Decoct with two zhan of water and five slices of Shengjiang (Zingiberis Rhizoma Recens), and take orally. Add Danggui (Angelicae Sinensis Radix) and Chuanxiong (Ligustici Chuanxiong Rhizoma).
Baifuzi Wan (White Nodule Pill): Treats wind-phlegm rushing upward, causing dizziness and headache.
Quanxie (Scorpio, 0.5 liang, roasted), Baifuzi (Typhonii Rhizoma, prepared), Nanxing (Arisaematis Rhizoma, prepared), Banxia (Pinelliae Rhizoma), Xuanjinhua (Inulae Flos), Ganju (Chrysanthemi Flos), Tianma (Gastrodiae Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma), Juhong (Citri Reticulatae Pericarpium Rubrum), Jiangcan (Bombyx Batryticatus, roasted), Ganjiang (Zingiberis Rhizoma, raw) (each 2 liang).
Grind into powder. Extract juice from half a jin of Shengjiang (Zingiberis Rhizoma Recens), make a paste, and form pills the size of tung tree seeds. Take 50 pills with Jingjie (Schizonepetae Spica) decoction.
Renshen Qianhu Tang (Ginseng and Peucedanum Decoction): Treats dizziness and vertigo due to wind-phlegm.
Banxiaqu (Pinelliae Fermentatum), Muxiang (Aucklandiae Radix), Zhike (Aurantii Fructus, roasted), Zisu (Perillae Folium), Chi Fuling (Poria with Red Wood), Nanxing (Arisaematis Rhizoma, prepared), Gancao (Glycyrrhizae Radix et Rhizoma, roasted) (each 5 qian), Renshen (Ginseng Radix et Rhizoma, 3 qian), Qianhu (Peucedani Radix, 5 qian), Juhong (Citri Reticulatae Pericarpium Rubrum, 5 qian).
Grind into coarse powder. Take 5 qian per dose, with five slices of Shengjiang (Zingiberis Rhizoma Recens), decoct in water, and take orally.
Xiongchu Xuansan (Ligusticum and Atractylodes Dizziness-Dispelling Powder): Treats head heaviness and dizziness due to dampness and cold invasion.
Fuzi (Aconiti Lateralis Radix Preparata, raw), Baizhu (Atractylodis Macrocephalae Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma) (each 0.5 liang), Guigui (Cinnamomi Cortex), Gancao (Glycyrrhizae Radix et Rhizoma, roasted) (each 2.5 qian).
Grind into coarse powder. Take 3 qian per dose, with seven slices of ginger, decoct in water, and take orally.
Fuling Guizhi Baizhu Gancao Tang (Poria, Cinnamon Twig, Atractylodes Macrocephala, and Licorice Decoction): Treats qi rushing to the chest, trembling, and dizziness.
Fuling (Poria, 1 liang), Guizhi (Cinnamomi Ramulus, 7.5 qian), Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma, roasted) (each 0.5 liang).
Grind into coarse powder. Take 4 qian per dose, decoct in water, and take orally. For wind syndromes, add Chuanxiong (Ligustici Chuanxiong Rhizoma) and Xixin (Asari Radix et Rhizoma); for damp syndromes, add Chuanxiong (Ligustici Chuanxiong Rhizoma) and Cangzhu (Atractylodis Rhizoma); for cold syndromes, add Ganjiang (Zingiberis Rhizoma) and Liangjiang (Alpiniae Officinarum Rhizoma).
Banxia Baizhu Tianma Tang: See Headache category.
Zhengyuan San (Upright Qi Powder)
Hongdou (Vigna angularis, roasted, 3 qian), Renshen (Ginseng Radix et Rhizoma, 2 liang), Rougui (Cinnamomi Cortex, 0.5 liang), Fuzi (Aconiti Lateralis Radix Preparata, prepared, skin and buds removed), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shanyao (Dioscoreae Rhizoma, stir-fried with ginger juice), Wuyao (Linderae Radix) (each 1 liang), Chuanwu (Aconiti Radix, prepared, skin and navel removed, 0.5 liang), Ganjiang (Zingiberis Rhizoma, prepared, 3 qian), Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma, roasted), Fuling (Poria) (each 2 liang), Chenpi (Citri Reticulatae Pericarpium, 2 qian), Huangqi (Astragali Radix, roasted, 1.5 liang).
Cut into pieces. Take 3 qian per dose, with one zhan of water, three slices of ginger, one jujube, and a pinch of salt.
Heixi Dan (Black Tin Pill)
Rougui (Cinnamomi Cortex, 0.5 liang), Chenxiang (Aquilariae Lignum Resinatum), Fuzi (Aconiti Lateralis Radix Preparata, prepared, skin and navel removed), Guzhi (Psoraleae Fructus), Huluba (Trigonellae Semen, soaked in wine and roasted), Huixiang (Foeniculi Fructus, roasted), Roudoukou (Myristicae Semen, baked in flour coating), Yangqishi (Crocidolite), Jinlingzi (Meliae Fructus, steamed, skin and pits removed), Muxiang (Aucklandiae Radix) (each 1 liang), Liuhuang (Sulfur), Heixi (Black Tin, purified) (each 2 liang).
Use a black-glazed bowl or a new iron pot. Following standard procedures, refine Heixi (Black Tin), Liuhuang (Sulfur), and Shazi (Sand). Bury in the ground to eliminate fire toxicity. Grind extremely fine. Pulverize remaining herbs and sieve them. Mix all powders uniformly. Grind continuously from morning to evening until the mixture shines black. Make pills with wine paste, sized like tung tree seeds. Dry in shade. Place in a cloth bag and polish until shiny. Take 40 pills per dose on an empty stomach with salt-ginger water or jujube water; women should take with mugwort-jujube water.
Shenzhuo Tang: See Lower Back Pain category.
Chuanxiong Chatiao San: See Headache category.