经言诸风掉眩。皆属肝木。则眩者风之所作。而肝之所主。河间则责于火。
火炎上而动摇也。丹溪则责于痰。痰流动而冲溢也。然治火并治痰。而眩
如故者何耶。良缘火之有余。本于水之不足。则壮水之主。钱氏六味丸加
鹿茸是也。痰之所发。由于水之上泛。则益火之原。仲景肾气丸补而逐之
是也。使根本坚实。即枝叶扶苏。孰得而震撼之哉。其次则莫如培土。木克
土。而实藉土以自栽。有如思虑太过。则调以归脾。劳役不节。则益以补中。
使心火宁而不盗母气。肺金旺而化源益滋。更入杜仲枸杞山茱萸之属。
上病下取。则鲜有不安者也。盖眩为中之始基。中为眩之究竟。其所以致
此者。未有不戕。贼真阴而得。则又何容讳耶。
一体虚之人。外感六淫。内伤七情。皆能眩晕。当以脉证别之。
一气虚者。乃清气不能上升。或汗多亡阳而致。当升阳补气。血虚者。乃亡
血过多。阳无所附而然。当益阴补血。此皆不足之症也。痰涎郁遏者。宜
开痰导郁。重则吐下。风火所动者。宜清上降火。外感四气。散邪为主。此
皆有余之症也。刘宗浓辨之颇详。要之素无病而忽眩者。当于有余中
求之。素不足而眩者。当于先后天分之。不得以气血该也。
本事川芎散 治肝风眩晕。
山茱萸（一两） 小川芎 人参 山药 茯神 甘菊花（各半两）
为末。每服二钱。酒调下。
钩藤散 治肝火头晕。兼有痰者。
钩藤 陈皮 麦门冬 半夏 茯神 甘菊花 人参 防风 白茯苓（各半两） 甘草（一钱） 石膏（一两）
每服四钱。姜七片。水煎。
许学士二方。用意颇微。不可忽视。
古籍记载：“各种风病引起的震颤和眩晕，都归属于肝木。”因此，眩晕是风邪所作，由肝脏所主。刘河间则归咎于火，因为火性炎上且动摇不定。朱丹溪则归咎于痰，因为痰液流动并冲逆溢出。然而，如果治疗火邪和痰浊后，眩晕依然如故，这是为什么呢？这主要是因为火之有余，根本在于水之不足。所以应当壮水之主（滋补肾阴），钱乙的六味丸加鹿茸就是这种方法。痰的产生，是由于肾水上泛，所以应当益火之原（温补肾阳），张仲景的肾气丸补益并驱逐水湿就是这种方法。如果根本坚实，枝叶自然茂盛，谁还能使其动摇呢？其次，莫过于培补脾胃。虽然木克土，但树木实际上依赖土壤来扎根生长。例如思虑过度，就用归脾汤调理；劳役不节，就加用补中益气汤。使心火安宁而不盗取母脏之气，肺金旺盛而化源更加滋润。再加入杜仲、枸杞、山茱萸等药物，上病下取，那么很少有不痊愈的。大概眩晕是中风的起始基础，中风是眩晕的最终结果。导致这种情况的原因，无不伤害真阴，又有什么可隐瞒的呢？
体质虚弱的人，外感六淫（风、寒、暑、湿、燥、火六种外感病邪），内伤七情（喜、怒、忧、思、悲、恐、惊七种情志），都能引起眩晕。应当通过脉象和证候来辨别。
气虚者，是因为清气不能上升，或者因汗出过多亡失阳气所致，应当升阳补气。血虚者，是因为失血过多，阳气无所依附所致，应当益阴补血。这些都属于不足的病症。痰涎郁结阻滞者，宜化痰导滞，病情重的可用吐法或下法。风火扰动者，宜清上焦之火并降火。外感四时不正之气，以疏散邪气为主。这些都属于有余的病症。刘宗浓对此辨析得很详细。总之，平素无病而突然眩晕的，应当在“有余”方面寻求原因；平素体虚而眩晕的，应当从先天和后天分辨，不能仅用气血来概括。
本事川芎散：治疗肝风眩晕。
山茱萸（一两）、小川芎、人参、山药、茯神、甘菊花（各半两）。
研为细末，每次服用二钱，酒调服。
钩藤散：治疗肝火头晕，兼有痰者。
钩藤、陈皮、麦门冬、半夏、茯神、甘菊花、人参、防风、白茯苓（各半两）、甘草（一钱）、石膏（一两）。
每次服用四钱，生姜七片，水煎服。
许学士的两个方子，用意颇为精微，不可忽视。
Classical texts state: "All wind diseases causing tremors and dizziness belong to Liver Wood." Therefore, dizziness is caused by Wind pathogen and is governed by the Liver. Liu Hejian attributes it to Fire, as Fire flares upward and causes shaking. Zhu Danxi attributes it to Phlegm, as Phlegm flows and surges. However, if treating Fire and Phlegm does not resolve the dizziness, why is this? The reason lies in that excessive Fire stems from insufficient Water. Thus, one should strengthen the Master of Water (nourish Kidney Yin), such as using Qianyi's Liuwei Wan (Six-Ingredient Pill with Rehmannia) plus Lu Rong (Cervum Cornu). The emergence of Phlegm results from the flooding of Kidney Water; therefore, one should benefit the Source of Fire (warm Kidney Yang), such as using Zhang Zhongjing's Shenqi Wan (Kidney Qi Pill) to tonify and expel. If the root is solid, the branches and leaves will flourish naturally, and who could shake it? Secondly, nothing is better than fortifying Earth (Spleen/Stomach). Although Wood controls Earth, plants actually rely on Earth to take root. For instance, due to excessive mental worry, regulate with Guipi Tang (Restore the Spleen Decoction); due to irregular labor and fatigue, add Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). This calms Heart Fire so it does not steal Qi from its Mother organ, and strengthens Lung Metal so the source of transformation is nourished further. Adding herbs like Duzhong (Eucommiae Cortex), Gouqi (Lycii Fructus), and Shanzhuyu (Corni Fructus), treating upper disorders by targeting the lower, rarely fails to bring peace. Generally, dizziness is the initial basis of Stroke (Zhong Feng), while Stroke is the ultimate outcome of dizziness. The cause of this condition invariably damages True Yin, so there is no need to conceal this fact.
Individuals with a deficient constitution can experience dizziness from external contraction of the Six Excesses (Wind, Cold, Summerheat, Dampness, Dryness, Fire) or internal injury of the Seven Emotions (Joy, Anger, Worry, Pensiveness, Sadness, Fear, Fright). One must distinguish them by pulse and syndrome.
Qi deficiency arises because clear Yang cannot ascend, or results from excessive sweating leading to loss of Yang. Treatment should involve raising Yang and tonifying Qi. Blood deficiency occurs due to excessive blood loss, leaving Yang without attachment. Treatment should involve benefiting Yin and tonifying Blood. These are all Deficient syndromes. When Phlegm-Dampness is stagnant and obstructing, one should resolve Phlegm and guide out stagnation; for severe cases, induce vomiting or purgation. When moved by Wind-Fire, one should clear the Upper Jiao and descend Fire. For external contraction of the Four Seasons' abnormal Qi, dispersing pathogens is primary. These are all Excess syndromes. Liu Zongnong analyzed this in detail. In summary, for those previously healthy who suddenly develop dizziness, seek the cause within Excess patterns; for those chronically deficient who develop dizziness, differentiate between Congenital (Pre-heaven) and Acquired (Post-heaven) deficiencies, rather than merely categorizing under Qi and Blood.
Ben Shi Chuanxiong San (Chuanxiong Powder from Essential Skills): Treats Liver Wind dizziness.
Shanzhuyu (Corni Fructus) (1 liang), Xiaochuanxiong (Rhizoma Chuanxiong), Renshen (Ginseng Radix et Rhizoma), Shanyao (Dioscoreae Rhizoma), Fushen (Poria with Hostwood), Ganjuhua (Chrysanthemi Flos) (each 0.5 liang).
Grind into powder. Take 2 qian per dose, mixed with wine.
Gouteng San (Uncaria Decoction): Treats Liver Fire dizziness accompanied by Phlegm.
Gouteng (Uncariae Ramulus cum Uncis), Chenpi (Citri Reticulatae Pericarpium), Maimendong (Ophiopogonis Tuber), Banxia (Pinelliae Rhizoma), Fushen (Poria with Hostwood), Ganjuhua (Chrysanthemi Flos), Renshen (Ginseng Radix et Rhizoma), Fangfeng (Saposhnikoviae Radix), Bai Fuling (Poria), Gancao (Glycyrrhizae Radix et Rhizoma) (1 qian), Shigao (Gypsum Fibrosum) (1 liang).
Take 4 qian per dose, with 7 slices of fresh ginger, decocted in water.
The two prescriptions by Scholar Xu have subtle intentions and should not be overlooked.