本事川芎散治风眩头晕
山茱萸(一两) 山药 甘菊花 人参 茯神 小川芎(各半两)
上为末每服二钱酒调下
按此名治风眩而用药带补肝之意若因风而头眩者分其所挟寒热而用辛温辛凉之剂可也若
因肝虚而病者此药虽近理亦难执此而用
严氏三五七散治阳虚风寒入脑头痛目眩耳鸣
天雄(炮去皮) 细辛(各三两) 山茱萸 干姜(炮各五两) 防风 山药(炒各七两)
上为末每服二钱温酒调下
按此治上焦阳虚发散风寒之药也若果有风寒所伤而头眩者但用辛温辛热之剂解散可也何
必拘此
严氏芎术汤治冒雨中湿眩晕呕逆头重不食
川芎 半夏 白术(各一两) 甘草(炙半两)
上 咀每服四钱姜七片煎
按此和中散湿之药也亦可治痰
子和芎黄汤治头目眩晕
大黄 荆芥 川芎 防风(各等分)
上为粗末大作剂料水煎去滓服以利为度
按此泻上焦风热之药也若果有风热头眩如防风通圣之类皆可选拣而用
严氏玉液汤治七情感动气郁生涎随气上逆头目眩晕心嘈忪悸眉棱骨痛
大半夏(汤洗七次)
上每服四钱水煎生姜十片煎入沉香水一呷温服
风痰眩晕者宜青州白丸子选用
直指二陈汤治因气郁痰眩晕
二陈加干生姜煎服
按此二方去痰和中之平剂足太阴阳明经药也若痰气甚者如吐下之法皆可施自宜随证而用
去痰和中瑞竹堂化痰丸亦妙(方见咳门)
【本事方】川芎散:治疗风眩、头晕。
山茱萸(一两)、山药、甘菊花、人参、茯神、小川芎(各半两)。
以上药物研为细末,每次服用二钱,用酒调服。
按语:此方名为治疗风眩,但用药中带有补益肝脏的意图。如果是因外风侵袭导致头眩,应根据所兼夹的寒热属性,分别选用辛温或辛凉的药物即可。如果是因肝虚而发病,此药虽然合乎情理,但也难以拘泥于此方使用。
严氏三五七散:治疗阳虚风寒入脑引起的头痛、目眩、耳鸣。
天雄(炮制去皮)、细辛(各三两)、山茱萸、干姜(炮制,各五两)、防风、山药(炒制,各七两)。
以上药物研为细末,每次服用二钱,用温酒调服。
按语:此方是治疗上焦阳虚、发散风寒的药物。如果确实有风寒损伤导致的头眩,只需使用辛温、辛热的药物解散风寒即可,何必拘泥于这一方?
严氏芎术汤:治疗冒雨受湿引起的眩晕、呕逆、头重、食欲不振。
川芎、半夏、白术(各一两)、甘草(炙制,半两)。
以上药物切碎,每次服用四钱,加生姜七片煎煮。
按语:此方是和胃散湿的药物,也可以治疗痰证。
子和芎黄汤:治疗头目眩晕。
大黄、荆芥、川芎、防风(各等分)。
以上药物捣成粗末,大量作为剂料用水煎煮,去渣服用,以大便通畅为度。
按语:此方是泻除上焦风热的药物。如果确实有风热导致的头眩,如防风通圣散之类都可以选择使用。
严氏玉液汤:治疗因七情触动、气郁生涎,随气上逆引起的头目眩晕、心中嘈杂悸动、眉棱骨疼痛。
大半夏(汤洗七次)。
以上每次服用四钱,用水煎煮,加入生姜十片,再调入沉香水一呷,温服。
风痰眩晕者适宜选用青州白丸子。
直指二陈汤:治疗因气郁痰阻引起的眩晕。
二陈汤加干生姜煎服。
按语:这两个方子是祛痰和中的平和之剂,属于足太阴脾经和足阳明胃经的药物。如果痰气严重,如吐法、下法等都可以施用,应当根据证候灵活使用。
祛痰和中方面,瑞竹堂化痰丸也很妙(方剂见咳嗽门)。
Ben Shi Fang (Prescriptions from the Hand of Ability) Chuanxiong San: Treats wind-dizziness and vertigo.
Corni Fructus (Shanzhuyu, 山茱萸) (one liang), Dioscoreae Rhizoma (Shanyao, 山药), Chrysanthemi Flos (Gan Juhua, 甘菊花), Ginseng Radix et Rhizoma (Renshen, 人参), Poria (Fushen, 茯神), Chuanxiong Rhizome (Xiao Chuanxiong, 小川芎) (each half a liang).
The above are ground into powder; each dose is two qian, taken with wine mixed in.
Commentary: This prescription is named for treating wind-dizziness, but its ingredients carry the intention of tonifying the Liver. If dizziness is caused by external wind, one should select acrid-warm or acrid-cool preparations according to whether cold or heat is involved. If the disease arises from Liver deficiency, although this prescription is theoretically sound, it should not be rigidly applied.
Yan Shi San Wu Qi San (Strict's Three-Five-Seven Powder): Treats headache, vertigo, and tinnitus caused by wind-cold invading the brain due to Yang deficiency.
Aconiti Lateralis Radix Praeparata (Tianxiong, 天雄) (prepared, peeled) (three liang), Asari Radix (Xixin, 细辛) (three liang), Corni Fructus (Shanzhuyu, 山茱ume) (five liang), Zingiberis Rhizoma Recens (Ganjiang, 干姜) (prepared, five liang), Saposhnikoviae Radix (Fangfeng, 防风), Dioscoreae Rhizoma (Shanyao, 山药) (stir-fried, seven liang).
The above are ground into powder; each dose is two qian, taken with warm wine mixed in.
Commentary: This is a preparation for dispersing wind-cold in cases of upper Jiao Yang deficiency. If vertigo is indeed caused by wind-cold injury, simply using acrid-warm or acrid-hot preparations to disperse the pathogen is sufficient; why insist on this specific formula?
Yan Shi Xiong Zhu Tang (Strict's Chuanxiong and Atractylodes Decoction): Treats vertigo, retching, reversal of qi, heavy head, and loss of appetite caused by exposure to rain and dampness.
Chuanxiong Rhizome (Chuanxiong, 川芎), Pinelliae Rhizoma Preparatum (Banxia, 半夏), Atractodis Macrocephalae Rhizoma (Baizhu, 白术) (each one liang), Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) (honey-fried, half a liang).
The above are cut into pieces; each dose is four qian, decocted with seven slices of fresh ginger.
Commentary: This is a preparation that harmonizes the middle and scatters dampness; it can also treat phlegm conditions.
Hezi's Xionghuang Tang (Zihe Zheng's Chuanxiong and Rhubarb Decoction): Treats head and eye vertigo.
Rhei Radix et Rhizoma (Dahuang, 大黄), Schizonepetae Herba (Jingjie, 荆芥), Chuanxiong Rhizome (Chuanxiong, 川芎), Saposhnikoviae Radix (Fangfeng, 防风) (equal parts).
The above are crushed into coarse powder, prepared in large quantities as a dosage form, decocted in water, filtered, and taken until bowel movement occurs.
Commentary: This is a preparation for purging wind-heat from the upper Jiao. If vertigo is indeed caused by wind-heat, preparations such as Fangfeng Tongsheng San can be selected and used.
Yan Shi Yuye Tang (Strict's Jade Liquid Decoction): Treats head and eye vertigo, gastric discomfort with palpitations, and pain in the supraorbital ridge caused by emotional disturbance, qi stagnation generating saliva/phlegm, which rises with rebellious qi.
Pinelliae Rhizoma (Banxia, 大半夏) (washed seven times with hot water).
Each dose is four qian, decocted in water with ten slices of fresh ginger, then mixed with one sip of Aquae Sappanensis (Chenxiang Shui, 沉香水), taken warm.
For vertigo due to wind-phlegm, Qingzhou Baiwanzi is suitable.
Zhizhi Erchen Tang (Direct Pointers' Two-Chen Decoction): Treats vertigo caused by qi stagnation and phlegm.
Erchen Tang (Two-Chen Decoction) decocted with dried fresh ginger.
Commentary: These two prescriptions are mild agents for resolving phlegm and harmonizing the middle, belonging to the Foot-Taiyin Spleen and Foot-Yangming Stomach meridians. If phlegm and qi are severe, methods such as emesis or purgation may be applied; treatment should follow the specific syndrome.
For resolving phlegm and harmonizing the middle, Ruizhutang Huatan Wan (Ruizhu Hall Phlegm-Resolving Pill) is also excellent (formula see Cough section).