窦材治一人，头风发则旋晕呕吐，数日不食。为针风府穴，向左耳入三寸，去来留十三呼，病患头内觉麻
热，方令吸气出针，服附子半夏汤，永不发。华佗针曹操头风，亦针此穴，立愈。但此穴入针，人即昏倒。其
法向右耳横下针，则不伤大筋而无晕，乃千金妙法也。（此针法奇妙，须与高手针家议之，方得无误。）
龚子材诊熊槐二官，年六十余，身体胖大，其下手即得五至一止，乃惊曰∶君休矣。渠曰∶连日微觉头晕，
别无恙也，何故出此？愿实教焉。龚曰∶越十日用药。相哂而退。少顷间中痰，求救于龚。知其必不可治，令
以香油灌之即醒，逾十日果卒。
张路玉治董司业夫人，体虽不甚丰，而恒有眩晕之疾。诊其六脉皆带微弦，而气口尤甚。盖缘性多郁怒，
怒则饮食不思，而为眩晕矣。岂平常体肥多湿之痰，可比例乎。为疏六君子方，水泛为丸，服之以培中土，中
土健运，当无敷化不及，留结为痰而成眩晕之虑，所谓治病必求其本也。
朔客梁姓者，邀诊。时当夏日，裸坐盘餐，倍于常人，形伟气壮，热汗淋漓于头顶间。诊时不言所以，切
其六脉沉实，不似有病之候，惟两寸略显微数之象。但切其左，则以右掌抵额，切其右，则以左掌抵额，知其
肥盛多湿，而夏暑久在舟中，时火鼓激其痰而眩晕也。询之果然，因与导痰汤加黄柏、泽泻、茅术、浓朴，二
服而安。
吴友良，年逾古稀，头目眩晕。乃弟周维，素擅岐黄，与补中益气数服，始用人参一钱，加至三钱，遂痞
满不食，坐不得卧，三昼夜喃喃不休。（上盛下虚之症，服补中益气，其害如此。）诊时，见其面赤，进退不
常，左颊聂聂 动。其六脉皆促，或七八至一歇，或三四至一歇。询其平昔起居，云至五十即绝欲自保，饮啖
且强。此壮火烁阴，兼肝风上扰之兆，与生料六味，除去萸肉，入钩藤，大剂煎服。是夜即得酣寝，其后或加
炙鳖甲，或加龙齿，或加枣仁。有时妄动怒火，达旦不宁，连宵不已，则以秋石汤送灵砂丹，应如桴鼓。
盛夏酷暑，则以大剂
生脉散代茶，后与六味全料调理，至秋而安。
陆养愚治陈巽源室，向有头眩之症，不药亦止。八月中旬，偶作劳烦闷，饮酒数杯，坐月下，更余方寝，
便觉微热不安。次早忽眼黑头旋，且微痛，如在风云中，发比平时较剧。医谓脉得浮数，此热极生风也，用芩、
连、山栀等以清之。二剂眩晕不减，而头痛如破，上身如火，而欲浓覆。又谓无痰不作晕，再以清火之品合二
陈汤，二剂亦不效。脉之，左手浮弦而紧，右手浮数而弱，且寸强尺微。右脉乃正气之虚，左脉乃邪气之实，
尺微寸强，邪在上也。此必乘虚感邪，中于上焦所致。经曰∶筋骨血气之精，而与脉并为目系，上属于脑，后
出于项中，故邪中于项。因逢其之虚，其入深，则随目系以入于脑，入于脑则脑转，脑转则引目系急，目系急
则目眩以转矣。今作劳以致烦闷，非虚乎？月下坐至更余，头项之间，能不为雾露之阴所中乎？法当驱上焦之
邪，补中焦之气，而徐议消痰清火，则自愈矣。因先用参苏饮加 本，二剂头痛顿止，眩亦少瘥。再以补中益
气，佐以二陈、芩、连数剂而安。
张路玉治缪封君，偶因小愤，遂眩晕痞闷。三日来，服豁痰利气药不应，反觉疲倦，饮食日减，下元乏力。
诊之，六脉似觉有余，指下略无冲和之气，气口独滞不调，时大时小，两尺俱濡大少力。此素多痰湿，渐渍于
水土二经，加以剥削之剂屡犯中气，疲倦少食，殆所必致。法当先调中气，输运水谷之精微，然后徐图补下元。
为疏六君子汤加当归，调营血，庶无阳无以化之虞。
龚子材治大学士高中玄，患头目眩晕，耳鸣眼黑，如在风云中，目中溜火。或与清火化痰，或与滋补气血，
俱罔效。诊之，六脉洪数。此火动生痰，以酒蒸大黄三钱为末，茶下，一服而愈，火降则痰自清矣。
薛立斋治一妇人，头晕吐痰，用化痰理气药，肢体酸麻，服祛风化痰药，肢体常麻，手足或冷或热。
此脾土虚而不能生肺金，用补中益气加茯苓、半夏、炮姜，二十余剂而愈。后因怒吐痰，自服清气化痰丸，饮
食不进，吐痰甚多，胸胁胀满，教用六君子倍加参、术，少加木香，数剂而愈。
陶天爵，外家媵素多，时患头晕疼甚，劳则肢体痿软，筋骨作痛，殊类风症。以为肾虚，不能纳气归源，用
加减八味丸而痊。后因房劳气恼，头晕项强，耳下作痛。此肝火之症，仍用前药滋肾水，生肝血，制风火而愈。
张飞畴治一妇，胸满身热，六脉弦数无力，形色倦怠，渴不甚饮。云自游虎邱，晕船吐后，汗出发热头痛，
服发散四剂，胸膈愈膨，闻谷气则呕眩，热不退。医禁粥食已半月，日惟饮清茶三四瓯，今周身骨肉痛楚，转
侧眩晕呕哕。曰∶当风汗呕，外感有之，已经发散矣，吐则饮食已去，消克则更伤脾，脾虚故胀甚，脾绝谷气
则呕，土受木克则晕，宜勿药，惟与米粥，继进粥食，使脾土有主，更议可也。守其言，竟不药而愈。
立斋云∶上舍顾桐石，会饮周上舍第。问余曰∶向孟有涯、陈东谷，俱为无嗣纳宠，已而得疾，皆头晕吐
痰，并用苏合香丸，惟孟得生，何也？曰∶二症因肾虚，不能纳气，而为头晕，不能制水而为痰涎，陈专服攻
痰行气，孟专服益火补气故耳。后余他往，桐石房劳过度，亦患前症，或用清气化痰愈甚，顾曰∶我病是肾虚，
不能纳气归源。治者不悟而殁，惜哉！
昌平守王天成，头晕恶寒，形体倦怠，得食稍愈，劳而益甚，寸关脉浮。此脾肺虚弱，用补中益气加蔓荆
子而愈。后因劳役，发热恶寒，谵言不寐，得食稍安，用补中益气而痊。
大尹祝支山，因怒头晕，拗内筋挛，时或寒热，日晡热甚。此肝火筋挛，气虚头晕，用八珍汤加柴胡、山
栀、丹皮，二十余剂而愈。
按∶肝火亦作头晕，不定属之气虚也。经云∶诸风掉眩，皆属于肝，肝之脉上络颠顶。余尝以一气汤
加吴萸、炒黄连，二三剂即愈。
朱丹溪治一男子，年七十九岁，头目昏眩而重，手足无力，吐痰口口相续。左手脉散大而缓，右手缓而大，
大不及于左，重按皆无力。饮食略减而微渴，大便三四日一行。众人皆与风药，朱曰∶服此药至春深必死。此
皆大虚症，当以补药大剂服之。众愠而去，乃教用人参、黄 、当归、白芍、白术、陈皮，浓煎作汤，下连柏
丸三十粒。如此者服一年半，而精力如少壮时。连柏丸冬加干姜少许，余三时皆根据本法。连、柏皆姜汁炒为细
末，又以姜汁煮湖为丸。
按∶此症大补而佐以连、柏，妙不可言矣。盖一眼注定肝肾二经，以连清肝火，柏清肾火者也。既虑
其寒，重以姜汁制之，可谓尽善。然不若竟用地黄、杞子，如左归加减，尤为善中之善也。
陈自明治一妇人，苦头风，作晕数年，服太乙丹一粒，吐痰碗许，遂不再发。（方见虫门。）
冯楚瞻治金绍老夫人，因岁事积劳，忽眩晕不省，妄有见闻，语言杂乱。诊其脉，细数无伦，真阴真阳并
亏已极。乘此初起，既可挽回，愈久愈虚，愈虚愈脱矣。用全真一气汤，日进二剂，每剂人参八钱，不十日而全瘳。
钱国宾治陈叔明，幼年多读，抱学贫居，自甘清淡，有品士也。至三旬外，一见日光即觉昏晕，渐至见光
昏晕，遂坐于帐，凡有隙处莫敢窥，如是二十年矣，诸药遍尝。亲友怜其品行，时以升斗周之。与诊，乃阳虚
阴极之症，须返本还元之药可治也。用首经、人乳、脐带、胎发、秋石，炼蜜丸如芡实大，朱砂为衣，三更时
服下一丸，月余更愈。适钱有此丸，因与之也。
徐灵胎曰∶眩晕，清火养肝，固为正治。但阳气上升，至于身体不能自主，此非浮火之比，古人必用金石
镇坠之品。余初至郡中治病，是时喜用唐人方，叶天士先生见之，谓人曰∶有吴江秀才徐某，在外治病，颇有
心思，但药味甚杂，此乃无师传授之故。已后先生得宋板《外台秘要》读之，复谓人曰∶我前谓徐生立方无本，
谁知俱出《外台》。可知学问无穷，读书不可轻量也。先生之服善如此，犹见古风。所谓药味杂，即指金石品也。
窦材治疗一位患者，头风发作时出现旋转性眩晕和呕吐，连续几天无法进食。窦材针刺风府穴，针尖向左耳方向进针三寸，留针十三次呼吸的时间，患者感觉头部内部发麻发热，才让患者吸气时出针，随后服用附子半夏汤，从此不再复发。华佗治疗曹操的头风病，也是针刺这个穴位，立刻痊愈。但是这个穴位进针后，人就会昏倒。如果采用向右耳横向进针的方法，就不会损伤大筋且不会引起晕厥，这是千金妙法。（这种针法非常奇妙，必须与高水平的针灸专家商议，才能确保无误。）
龚子材诊治熊槐二官，年龄六十多岁，身体肥胖。诊脉时发现脉搏五至一止（代脉），于是惊讶地说：“您恐怕不行了。”患者说：“这几天只是稍微觉得头晕，没有其他不适，为什么这么说？希望您如实教导我。”龚子材说：“十天后用药。”患者嘲笑他后离开。不久后患者突然痰涌，向龚子材求救。龚子材知道病情已不可治，让人用香油灌服，患者随即苏醒，但十天后果然去世。
张路玉治疗董司业夫人，身体虽然不是很丰满，但经常患有眩晕疾病。诊察其六部脉象都带有微弦之象，而气口脉尤为明显。这是因为她性格多郁怒，愤怒导致饮食不思，从而引发眩晕。这怎么能与普通体胖多湿生痰的情况相提并论呢？于是开具六君子方，用水泛为丸，服用以培补中土（脾胃）。中土健运，则能正常化生精微，没有留结为痰而导致眩晕的忧虑，这就是所谓治病必求其本。
朔客梁姓患者，邀请张路玉诊治。当时正值夏日，他像平常人一样加倍地裸露坐着用餐，形体魁伟，气息壮盛，头顶间热汗淋漓。诊脉时他不说明病因，切脉发现六脉沉实，不像有病的征候，只有两寸脉略微显现数象。但在切左脉时，他用右掌抵住额头；切右脉时，用左掌抵住额头。张路玉判断他肥盛多湿，加上夏天长期在舟中，暑火鼓动其痰，导致眩晕。询问后果然如此，于是给予导痰汤加黄柏、泽泻、茅术、浓朴，服用两剂后安然无恙。
吴友良，年过七十，头目眩晕。他的弟弟周维，素来擅长中医，给他服用补中益气汤几剂后，开始用人参一钱，逐渐加到三钱，结果导致痞满不食，坐卧不安，三昼夜喃喃不休。（上盛下虚的症状，服用补中益气汤，危害如此之大。）诊脉时，见其面赤，神情进退无常，左脸颊微微跳动。六脉皆促，有时七八至歇止一次，有时三四至歇止一次。询问其平素起居，他说到了五十岁就断绝房事以自保，饮食勉强进食。这是壮火烁阴，兼有肝风上扰的征兆，给予生料六味地黄丸，除去萸肉，加入钩藤，大剂煎服。当晚即得熟睡，之后有时加炙鳖甲，或加龙齿，或加枣仁。有时妄动怒火，通宵不宁，就用秋石汤送服灵砂丹，效果如桴鼓相应。盛夏酷暑时，就用大剂生脉散代茶，后来用六味地黄丸全料调理，到秋天痊愈。
陆养愚治疗陈巽源之妻，向来有头眩症状，不吃药也能停止。八月中旬，偶然因劳累烦闷，饮酒数杯，坐在月下，直到更深夜静才睡觉，便觉得微热不安。第二天早上突然眼前发黑、头旋且微痛，像在风云中一样，发作比平时较剧烈。医生认为脉象浮数，这是热极生风，用黄芩、黄连、山栀等药清热。两剂后眩晕不减，反而头痛如破，上身如火，却想厚盖衣物。又说是无痰不作晕，再用清火药合二陈汤，两剂也不见效。诊脉，左手脉浮弦而紧，右手脉浮数而弱，且寸强尺微。右脉是正气虚，左脉是邪气实，尺微寸强，说明邪气在上焦。这一定是乘虚感邪，中于上焦所致。《内经》说：筋骨血气的精华，与脉并行为目系，上属于脑，后出于项中，所以邪气中于项。如果遇到人体虚弱，邪气深入，则随目系进入脑部，进入脑部则脑转，脑转则牵引目系急，目系急则目眩而旋转。现在因为劳累导致烦闷，这不是虚吗？坐在月下直到更深夜静，头项之间，能不受到雾露之阴邪侵袭吗？治法应当驱除上焦之邪，补益中焦之气，然后慢慢考虑消痰清火，就能自愈。于是先用参苏饮加藁本，两剂后头痛顿止，眩晕也稍减。再用补中益气汤，佐以二陈汤、黄芩、黄连数剂而安。
张路玉治疗缪封君，偶然因小愤，导致眩晕痞闷。三天来，服用豁痰利气药无效，反而觉得疲倦，饮食日渐减少，下元乏力。诊脉，六脉似乎有余，指下略无冲和之气，气口独滞不调，时大时小，两尺脉俱濡大少力。这是素来多痰湿，逐渐浸渍于脾肾二经，加上使用攻伐药剂多次损伤中气，疲倦少食，是必然的结果。治法应当先调和中气，输运水谷的精微，然后慢慢图谋补益下元。于是开具六君子汤加当归，调和营血，以免出现“无阳无以化”的担忧。
龚子材治疗大学士高中玄，患头目眩晕，耳鸣眼黑，像在风云中，眼中冒火。有人用清火化痰药，有人用滋补气血药，都无效。诊脉，六脉洪数。这是火动生痰，用酒蒸大黄三钱研末，茶水送服，一服而愈，火降则痰自清。
薛立斋治疗一位妇人，头晕吐痰，用化痰理气药，肢体酸麻；服祛风化痰药，肢体常麻，手足或冷或热。这是脾土虚不能生肺金，用补中益气汤加茯苓、半夏、炮姜，二十余剂而愈。后来因怒吐痰，自服清气化痰丸，饮食不进，吐痰甚多，胸胁胀满，教她用六君子汤倍加人参、白术，少加木香，数剂而愈。
陶天爵的外家媵妾，素来多痰，时常患头晕疼甚，劳累则肢体痿软，筋骨作痛，很像风症。认为是肾虚，不能纳气归源，用加减八味丸而痊愈。后来因房劳气恼，头晕项强，耳下作痛。这是肝火之症，仍用前药滋肾水，生肝血，制风火而愈。
张飞畴治疗一妇人，胸满身热，六脉弦数无力，形色倦怠，渴不甚饮。她说自从游览虎丘，晕船呕吐后，汗出发热头痛，服用发散药四剂，胸膈更加膨满，闻谷气则呕眩，热不退。医生禁止吃粥食半个月，每天只喝清茶三四碗，现在周身骨肉痛楚，转侧眩晕呕哕。张飞畴说：当风汗出呕吐，确实有外感，但已经发散过了，呕吐则饮食已去，消克则更伤脾，脾虚故胀甚，脾绝谷气则呕，土受木克则晕，宜勿药，只给米粥，继进粥食，使脾土有主，再议其他。遵守他的话，竟不药而愈。
薛立斋说：上舍顾桐石，在周上舍家聚会饮酒。问我道：以前孟有涯、陈东谷，都为无嗣纳妾，随后得病，都是头晕吐痰，都用苏合香丸，只有孟有涯得救，为什么呢？我说：这两个病症因为肾虚，不能纳气，而为头晕，不能制水而为痰涎，陈东谷专服攻痰行气药，孟有涯专服益火补气药的缘故。后来我去别处，顾桐石房劳过度，也患前症，或用清气化痰丸加重，顾说：我的病是肾虚，不能纳气归源。治者不明白而死，可惜啊！
昌平守王天成，头晕恶寒，形体倦怠，得食稍愈，劳而益甚，寸关脉浮。这是脾肺虚弱，用补中益气汤加蔓荆子而愈。后来因劳役，发热恶寒，谵言不寐，得食稍安，用补中益气汤而痊愈。
大尹祝支山，因怒头晕，拗内筋挛，时或寒热，日晡热甚。这是肝火筋挛，气虚头晕，用八珍汤加柴胡、山栀、丹皮，二十余剂而愈。
按语：肝火也会引起头晕，不一定都属于气虚。《内经》说：诸风掉眩，皆属于肝，肝之脉上络颠顶。我曾以一气汤加吴茱萸、炒黄连，二三剂即愈。
朱丹溪治疗一男子，七十九岁，头目昏眩而重，手足无力，吐痰口口相续。左手脉散大而缓，右手缓而大，大不及于左，重按皆无力。饮食略减而微渴，大便三四日一行。众人都用风药，朱丹溪说：服此药至春深必死。这都是大虚症，应当以大剂补药服用。众人愤怒离去，于是教用人参、黄芪、当归、白芍、白术、陈皮，浓煎作汤，下连柏丸三十粒。如此服药一年半，精力如少年壮年时。连柏丸冬天加少许干姜，其余三个季节都根据本法。黄连、黄柏都用姜汁炒为细末，又以姜汁煮糊为丸。
按语：此症大补而佐以黄连、黄柏，妙不可言。一眼注定肝肾二经，以黄连清肝火，黄柏清肾火。既担心其寒凉，重用姜汁制约，可谓尽善。然而不如直接用熟地黄、枸杞子，如左归丸加减，更是善中之善。
陈自明治疗一妇人，苦于头风，作晕数年，服太乙丹一粒，吐痰一碗许，遂不再发。（方见虫门。）
冯楚瞻治疗金绍老夫人，因岁事积劳，忽然眩晕不省人事，妄有见闻，语言杂乱。诊脉，细数无伦，真阴真阳并亏已极。趁此初起，既可挽回，愈久愈虚，愈虚愈脱。用全真一气汤，日进二剂，每剂人参八钱，不到十日而全愈。
钱国宾治疗陈叔明，幼年多读，抱学贫居，自甘清淡，是有品位的士人。到了三十岁外，一见日光就觉得昏晕，渐至见光昏晕，于是坐在帐子里，凡有缝隙的地方都不敢窥视，这样二十年，诸药遍尝。亲友怜惜他的品行，时常以升斗接济他。钱国宾为他诊脉，乃是阳虚阴极之症，须用返本还元之药可治。用首经、人乳、脐带、胎发、秋石，炼蜜丸如芡实大，朱砂为衣，三更时服下一丸，月余更愈。恰好钱某有此丸，因此给了他。
徐灵胎说：眩晕，清火养肝，固然是正治。但阳气上升，至于身体不能自主，这不是浮火可比拟的，古人必定用金石镇坠之品。我刚到郡中治病时，喜欢用唐人方，叶天士先生见到后，对人说：有吴江秀才徐某，在外治病，颇有心思，但药味很杂，这是无师传授的缘故。后来先生得到宋版《外台秘要》阅读，又对人说：我之前说徐生立方无本，谁知都出自《外台》。可知学问无穷，读书不可轻视。先生接受优点如此，犹见古风。所谓药味杂，即指金石品。
Dou Cai treated a patient whose head wind (headache disorder) caused rotational vertigo and vomiting, preventing food intake for several days. Dou Cai punctured the Fengfu (GV16) acupoint, inserting the needle three cun towards the left ear, retaining it for thirteen breaths. The patient felt numbness and heat inside the head. Only then was the needle withdrawn while the patient inhaled. After taking Fuzi Banxia Tang (Aconite and Pinellia Decoction), the condition never recurred. Hua Tuo also treated Cao Cao's head wind by puncturing this same acupoint, resulting in immediate recovery. However, puncturing this acupoint usually causes fainting. If the needle is inserted horizontally towards the right ear, it will not damage the major tendons nor cause dizziness; this is a wonderful method from Qianjin Fang. (This acupuncture technique is miraculous and must be discussed with expert acupuncturists to ensure accuracy.)
Gong Zicai diagnosed Guan Xiong Huai, aged over sixty, who was obese. Upon palpating the pulse, he found a intermittent pulse (Dai Mai, characterized by regular pauses). He exclaimed in surprise, "You are likely to perish." The patient replied, "I have only felt slightly dizzy these past few days, with no other discomfort. Why do you say this? Please teach me honestly." Gong said, "Medication will be administered in ten days." The patient laughed and left. Soon after, the patient suddenly experienced excessive phlegm and sought help from Gong. Knowing the condition was incurable, Gong instructed someone to pour sesame oil into the patient's mouth, which revived him temporarily, but he died exactly ten days later.
Zhang Luyu treated the wife of Director Dong, who was not particularly stout but suffered from chronic vertigo. Her six pulses were all slightly wiry (Xian Mai), especially at the Qi Kou (radial artery position corresponding to the Lung meridian). This was due to her prone to depression and anger; anger led to loss of appetite, causing vertigo. How could this be compared to ordinary cases of obesity with damp-phlegm? He prescribed Liujunzi Tang (Six Gentlemen Decoction), formed into pills with water paste, to tonify the Middle Jiao (Spleen and Stomach). With robust Spleen function, transformation would proceed normally, preventing phlegm accumulation that causes vertigo. This embodies the principle that treating disease requires seeking its root.
A merchant surnamed Shuo invited Zhang Luyu for consultation. It was summer, and unlike others, he ate meals naked while sitting, appearing robust and vigorous, with sweat dripping from his head. During consultation, he did not explain the cause. His six pulses were deep and solid (Chen Shi Mai), not resembling illness, except the two Cun positions were slightly rapid (Shu Mai). When feeling the left pulse, he held his right palm against his forehead; when feeling the right pulse, he held his left palm against his forehead. Zhang deduced he had excess dampness due to obesity, and prolonged exposure to boat travel in summer heat stirred up phlegm, causing vertigo. Inquiry confirmed this. He prescribed Daotan Tang (Phlegm-Expelling Decoction) modified with Huangbai (Phellodendron Bark), Zexie (Alisma Rhizome), Maoyu Zhu (Atractylodes Lancea), and Houpo (Magnolia Bark). Two doses brought relief.
Wu Youliang, over seventy years old, suffered from head and eye vertigo. His brother Zhou Wei, proficient in medicine, initially gave Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). Starting with one qian of Renshen (Ginseng Root) and increasing to three qian, the patient developed abdominal fullness, anorexia, inability to sit or lie down comfortably, and muttering day and night. (For symptoms of Upper Excess and Lower Deficiency, using Buzhong Yiqi Tang causes such harm.) Upon examination, his face was red, movements erratic, and left cheek twitched. His pulses were hurried (Cu Mai), pausing every 7-8 beats or every 3-4 beats. Inquiry revealed he had abstained from sexual activity since age fifty to preserve health and forced himself to eat. This indicated vigorous fire consuming Yin, accompanied by Liver Wind disturbing upwards. He was given Shengliao Liuwei Wan (Raw Six-Ingredient Pill) modified by removing Cornus Fruit and adding Gouteng (Uncaria Ramulus), in large doses. He slept soundly that night. Later, Chizhejia (Burned Turtle Shell), Longchi (Dragon Bone), or Zaoren (Ziziphus Seed) were added as needed. For episodes of anger and insomnia lasting all night, Qiushi Tang (Ash Decoction) was used to deliver Lingsha Dan (Cinnabar Pill), yielding immediate results. In midsummer heat, Shengmai San (Generate the Pulse Powder) was taken as tea instead. Finally, complete Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) was used for conditioning, leading to recovery by autumn.
Lu Yangyu treated the wife of Chen Xunyuan, who previously had occasional vertigo that resolved without medication. In mid-August, after labor and mental distress, she drank several cups of wine, sat under the moon until late at night, and then slept, feeling slight heat and unease. The next morning, she suddenly experienced blackouts, spinning vertigo, and mild pain, feeling as if in a storm, worse than usual. A physician diagnosed floating and rapid pulses as extreme heat generating wind, prescribing Qingre (Clear Heat) herbs like Huangqin (Scutellaria Root), Huanglian (Coptis Rhizome), and Zhizi (Gardenia Fruit). After two doses, vertigo persisted, headache worsened to splitting sensation, upper body felt hot, yet she desired heavy coverings. Another diagnosis suggested "no vertigo without phlegm," prescribing Qinghuo (Clear Fire) herbs combined with Erchen Tang (Two-Aged Decoction). Two doses failed. Pulse diagnosis showed left hand floating, wiry, and tight; right hand floating, rapid, and weak, with strong Cun and weak Chi positions. Right pulse indicates deficiency of righteous Qi; left pulse indicates excess of pathogenic factors. Strong Cun and weak Chi indicate pathology in the Upper Jiao. This was contraction of pathogens due to deficiency in the Upper Jiao. The Classic states: Essence of sinews, bones, blood, and qi form the Eye System, connecting to the brain and emerging from the neck. Thus, pathogens strike the neck. If the body is deficient, pathogens penetrate deeply, entering via the Eye System into the brain. Brain rotation pulls the Eye System taut, causing vertigo. Labor caused distress (deficiency); sitting under the moon exposed the neck to cold-damp mist. Treatment should expel Upper Jiao pathogens, tonify Middle Jiao Qi, and slowly resolve phlegm and clear heat. Shen Su Yin (Ginseng and Perilla Decoction) modified with Gaoben (Ligusticum Chuanxiong Rhizome) was given first. Two doses stopped the headache and reduced vertigo. Then, Buzhong Yiqi Tang was used with Erchen Tang, Huangqin, and Huanglian for several doses, achieving stability.
Zhang Luyu treated Miao Fengjun, who developed vertigo and chest fullness after minor anger. For three days, phlegm-resolving and Qi-moving medicines failed, causing fatigue and reduced intake, with weakness in the Lower Yuan. Pulses seemed abundant but lacked harmony; Qi Kou was stagnant and irregular, varying in size. Both Chi pulses were soggy, large, and weak. This indicated inherent damp-phlegm infiltrating the Earth (Spleen) and Water (Kidney) meridians, exacerbated by repeated use of draining agents damaging Middle Qi. Treatment应先调中气 (first regulate Middle Qi) to transport essence, then gradually tonify Lower Yuan. Liujunzi Tang (Six Gentlemen Decoction) plus Danggui (Angelica Sinensis Root) was prescribed to nourish Ying and Blood, avoiding issues of "Yang cannot transform without Yin."
Gong Zicai treated Grand Secretary Gao Zhongxuan, suffering from head/eye vertigo, tinnitus, visual obscurity, feeling like being in a storm, with fire flashing in eyes. Clearing heat/phlegm or tonifying Qi/blood were ineffective. Pulses were flooding and rapid. This was fire stirring phlegm. Jiuzheng Dahuang (Wine-processed Rhubarb) 3 qian was powdered and taken with tea. One dose cured it; lowering fire cleared phlegm naturally.
Xue Lizhai treated a woman with vertigo and expectoration. Phlegm-resolving/Qi-regulating meds caused limb soreness/numbness; wind-dispelling/phlegm-resolving meds caused constant numbness and alternating cold/hot extremities. This was Spleen Earth deficiency failing to generate Lung Metal. Buzhong Yiqi Tang plus Fuling (Poria), Banxia (Pinellia Tuber), and Paojiang (Prepared Ginger) cured her in 20+ doses. Later, anger-induced vomiting of phlegm occurred after self-medicating with Qingqi Huatan Wan. Anorexia, copious phlegm, and hypochondriac distension resulted. She was taught to use Liujunzi Tang with doubled Renshen and Baizhu, plus small amounts of Muxiang (Aucklandia Root), curing her in a few doses.
Tao Tianjue's concubine often suffered severe vertigo and pain, with limb flaccidity and bone/joint pain upon exertion, resembling wind disorders. Diagnosed as Kidney deficiency failing to grasp Qi, Jiajian Bawei Wan (Modified Eight-Ingredient Pill) cured her. Later, sexual exhaustion and anger caused vertigo, stiff neck, and ear pain. This was Liver Fire. Previous pills were reused to nourish Kidney Water, generate Liver Blood, and subdue wind-fire, leading to recovery.
Zhang Feichou treated a woman with chest fullness, body heat, wiry-rapid-weak pulses, fatigue, and slight thirst. She reported晕船 (seasickness) and vomiting after visiting Tiger Hill, followed by sweating, fever, and headache. Four doses of dispersing herbs worsened chest distension; smelling grain induced vomiting/vertigo; fever persisted. Doctors forbade porridge for half a month; she drank only weak tea. Now, whole-body pain, turning-induced vertigo/vomiting occurred. Zhang said: Wind-exposure with sweating/vomiting suggests exterior pathogen, already dispersed. Vomiting depleted food; purging damaged Spleen. Spleen deficiency causes distension; Spleen failure causes vomiting; Wood overcoming Earth causes vertigo. Stop medication; give only rice porridge to support Spleen Earth. Following this, she recovered without drugs.
Xue Lizhai recounted: Gu Tongshi asked why Meng Youya survived vertigo/phlegm treated with Suhexiang Wan (Styrax Pill) while Chen Donggu did not, despite similar presentations. Xue explained both had Kidney deficiency failing to grasp Qi (causing vertigo) and control Water (causing phlegm). Chen took phlegm-draining/Qi-moving drugs; Meng took Fire-tonifying/Qi-supplementing drugs. Later, Gu Tongshi overindulged sexually, developed similar symptoms, and worsened with Qingqi Huatan Wan. He realized his issue was Kidney deficiency failing to grasp Qi. The physician failed to understand, and Gu died. Regrettable!
Wang Tiancheng, Prefect of Changping, had vertigo, aversion to cold, fatigue, improvement after eating, worsening with labor, and floating pulses at Cun/Guan. Spleen/Lung deficiency. Buzhong Yiqi Tang plus Manjingzi (Vitex Fruit) cured him. Later, labor-induced fever/cold, delirium, insomnia, improved with food. Buzhong Yiqi Tang cured him again.
Zhu Zhishan, County Magistrate, had vertigo from anger, muscle spasms, alternating chills/fever, worse in afternoon. Liver Fire causing spasms, Qi deficiency causing vertigo. Bazhen Tang (Eight-Treasure Decoction) plus Chaihu (Bupleurum Root), Zhizi, and Danpi (Moutan Cortex) cured him in 20+ doses.
Commentary: Liver Fire can cause vertigo, not just Qi deficiency. The Classic says: All wind, tremors, and vertigo belong to the Liver. Liver meridian connects to the vertex. I once cured such cases with Yi Qi Tang plus Wuyu (Evodia Fruit) and fried Huanglian in 2-3 doses.
Zhu Danxi treated a 79-year-old man with heavy vertigo, weak limbs, continuous expectoration. Left pulse scattered-large-slow; right pulse slow-large, smaller than left, powerless on deep pressure. Reduced diet, slight thirst, bowel movement every 3-4 days. Others used wind-dispersing herbs. Zhu said: Taking these will lead to death by late spring. This is severe deficiency. Large doses of tonics are needed. Others left angrily. Zhu prescribed Renshen, Huangqi (Astragalus Root), Danggui, Baishao (White Peony Root), Baizhu, and Chenpi (Tangerine Peel) decocted strongly, with Lianbai Wan (Coptis and Phellodendron Pill) 30 pills. Taken for 1.5 years, energy returned to youth. In winter, add dried ginger to Lianbai Wan; other seasons follow base method. Coptis and Phellodendron are stir-fried with ginger juice into powder, then pillified with ginger juice paste.
Commentary: Tonifying heavily while assisting with Coptis and Phellodendron is exquisite. Targeting Liver and Kidney meridians, Coptis clears Liver Fire, Phellodendron clears Kidney Fire. Ginger juice mitigates cold nature. Perfect. However, using Shudihuang (Rehmannia Root) and Gouqi (Goji Berry), like Zuogui Wan (Left Restoring Pill) modifications, would be even better.
Chen Ziming treated a woman suffering from head wind and vertigo for years. One pill of Taiyi Dan caused her to vomit a bowl of phlegm, and the condition never recurred. (Formula see Worm Section.)
Feng Chuzhan treated Elderly Jin Shao, who collapsed with sudden vertigo, unconsciousness, hallucinations, and incoherent speech after accumulated labor. Pulse was fine, rapid, and chaotic, indicating extreme depletion of True Yin and True Yang. At this early stage, it could be reversed; delay leads to further depletion and collapse. Quan Zhen Yi Qi Tang (Complete True One Qi Decoction) was given, two doses daily, each containing 8 qian of Renshen. Full recovery in less than ten days.
Qian Guobin treated Chen Shuming, a scholar living in poverty, clean-living. After thirty, he became dizzy upon seeing sunlight, eventually needing to stay in curtains avoiding light for 20 years. Tried many medicines. Friends helped financially. Qian diagnosed Yang deficiency and Yin extremity. Required return-to-root remedies. Shoujing (Platycodon Root), human milk, umbilical cord, fetal hair, and Qiushi (Mineral Ash) were honey-pilled, coated with Cinnabar. One pill taken at midnight. Improved significantly in a month. Coincidentally, someone else had this formula and provided it.
Xu Lingtai stated: Clearing fire and nourishing Liver is correct treatment for vertigo. But when Yang Qi rises uncontrollably, affecting bodily autonomy, it is not merely floating fire. Ancients used mineral sedatives. Early in my career, I favored Tang dynasty formulas. Ye Tianshi remarked: Scholar Xu from Wujiang treats well but mixes too many herbs due to lack of formal instruction. Later, Ye read Song edition of Waitai Miyao and admitted Xu's formulas derived from it. Learning is endless; do not underestimate reading. Ye's openness reflects ancient virtue. "Mixed herbs" referred to mineral sedatives.