诸风眩晕,有火有痰。左涩死血,右大虚看。
眩者,目乍黑乍明,KT KT 不定也。晕者,头昏目旋转,岑岑欲倒也。高巅而见
动象,风性为然,故眩晕者多属诸风。(或兼见恶风、项强等证。脉应浮。宜芎 散、东垣羌活汤之类。)
又不独一风也,有因于火者,有因于痰者,有因于死血者,有因于虚者。夫火性上
炎,冲于巅顶,动摇旋转,不言可知。(或兼见心烦、口燥、面赤耳鸣、嘈杂吞酸等证。脉应数。宜凉膈
散、防风通圣散之类。)胸中痰浊随气上升。头目位高而空明,清阳所注。淆浊之气,扰乱
其间。欲其不眩不晕,不可得矣。(或兼见吐痰呕饮、胸痞肠鸣等证。脉应滑。宜东垣半夏白术天麻汤、滚
痰丸、玉液汤之类。)诸阳上行于头,诸脉上注于目。血死,则脉凝泣。脉凝泣,则上注之
力薄矣。薄则上虚而眩晕生焉。其脉左手必涩。涩为滞涩,征死血之不流利也。(或
兼见胁痛、喜忘、目黄、便黑等证。宜四物汤、丹皮、红花、桃仁之类。)又为枯涩,征血液之不充足也。
谓之血虚眩晕亦可。(宜四物汤。)脉必征于左者,以左心主血,肝藏血,肾主液,为血之
源耳。头以法天,诸阳之首。又云清阳出上窍,而目在其中。清阳者气也,气不足则不能上达,以致头目
空虚,而眩晕时时作矣。其脉右手必大而无力,散漫空松之象也,谓之气虚眩晕亦可。脉必征于
右者,以右肺主气,脾生气,命门火为气之根耳。(宜补中益气汤、芎、归、菊花之类。)
各种风邪引起的眩晕,有的由火邪引起,有的由痰浊引起。左手脉象涩滞提示有瘀血,右手脉象洪大提示为虚证。
眩,是指眼前突然发黑又突然明亮,视物模糊不定的状态。晕,是指头部昏沉、眼睛感觉旋转,昏昏沉沉想要跌倒的感觉。病位在人体最高处(头顶)而出现动摇的现象,这是风邪的特性所致,所以眩晕大多归属于各类风邪致病。(或者兼见怕风、项部僵硬等症状。脉象应当浮。适宜使用川芎散、东垣羌活汤之类的方剂。)
不仅只有单一的风邪致病,还有因火邪引起的,因痰浊引起的,因瘀血引起的,因虚损引起的。火性炎上,冲犯至头顶,导致动摇旋转,这不言自明。(或者兼见心烦、口干舌燥、面红耳赤、耳鸣、胃中嘈杂泛酸等症状。脉象应当数。适宜使用凉膈散、防风通圣散之类的方剂。)胸中的痰浊随着气机上升。头目位置高且空灵清明,是清阳之气灌注的地方。浑浊之气扰乱了其中,想要它不眩不晕,是不可能的。(或者兼见呕吐痰涎饮水、胸脘痞闷、肠鸣等症状。脉象应当滑。适宜使用东垣半夏白术天麻汤、滚痰丸、玉液汤之类的方剂。)诸阳经之气上行于头,诸经脉之血上注于目。血液凝固停滞,则脉道凝涩不通。脉道凝涩,则上注的力量就薄弱了。力量薄弱则上部空虚而眩晕产生。其脉象左手必定涩滞。涩代表滞涩,征验了瘀血的不流利。(或者兼见胁痛、健忘、目黄、大便色黑等症状。适宜使用四物汤、牡丹皮、红花、桃仁之类的方剂。)又表现为枯涩,征验了血液的不充足。称之为血虚眩晕也可以。(适宜使用四物汤。)脉象必定在左手体现,是因为左心主血,肝藏血,肾主液,它们是血的源头。头部效法天道,是诸阳之首。又说清阳出于上窍,而眼睛在其中。清阳指的是气,气不足就不能上达,导致头目空虚,从而时时发生眩晕。其脉象右手必定大而无力,呈现散漫空松的形态,称之为气虚眩晕也可以。脉象必定在右手体现,是因为右肺主气,脾生气,命门之火是气的根本。(适宜使用补中益气汤、川芎、当归、菊花之类的方剂。)
Vertigo and dizziness caused by various wind pathogens may be due to fire or phlegm. A choppy pulse on the left indicates fixed blood stasis, while a large pulse on the right indicates deficiency.
Xuan (vertigo) refers to the sensation of eyes suddenly turning black then bright, with unstable and blurred vision. Yun (dizziness) refers to a heavy-headed feeling with a sensation of rotation in the eyes, accompanied by a desire to fall. When dynamic phenomena occur at the highest point of the body (the vertex), it is due to the nature of wind; therefore, vertigo and dizziness mostly belong to diseases caused by various winds. (Or accompanied by aversion to wind, neck stiffness, etc. The pulse should be floating. Suitable formulas include Xiong San [Safflower Powder] and Dongyuan Qianghuo Tang [Dongyuan Notopterygium Decoction].)
It is not only a single wind pathogen; there are cases caused by fire, phlegm, fixed blood stasis, and deficiency. Fire has an upward-burning nature, rushing to the vertex, causing shaking and rotation, which is self-evident. (Or accompanied by mental restlessness, dry mouth, red face, tinnitus, gastric discomfort, and acid regurgitation. The pulse should be rapid. Suitable formulas include Liangge San [Cooling the Diaphragm Powder] and Fangfeng Tongsheng San [Saposhnikovia Universal Relief Powder].) Turbid phlegm in the chest rises with the Qi. The head and eyes are located high and are clear and bright, where Clear Yang Qi pours in. If turbid Qi disturbs this area, it is impossible for them not to experience vertigo and dizziness. (Or accompanied by vomiting of phlegm and fluids, chest fullness, and borborygmus. The pulse should be slippery. Suitable formulas include Dongyuan Banxia Baizhu Tianma Tang [Dongyuan Pinellia, Atractodes, and Gastrodia Decoction], Guntan Wan [Rolling Phlegm Pill], and Yuye Tang [Jade Fluid Decoction].) The Yang meridians ascend to the head, and the vessels pour into the eyes. If blood becomes stagnant and congealed, the vessels become obstructed. If the vessels are obstructed, the force of blood ascending becomes weak. When weak, the upper part becomes deficient, leading to vertigo. The pulse on the left hand must be choppy. Choppy indicates stagnation, verifying the non-smooth flow of fixed blood stasis. (Or accompanied by hypochondriac pain, forgetfulness, yellow eyes, and black stool. Suitable formulas include Siwu Tang [Four Substances Decoction], Mudan Pi [Moutan Cortex], Honghua [Carthamus Flos], and Taoren [Prunus Semen].) It also appears as withered and choppy, verifying insufficient blood. This can also be called blood-deficiency vertigo. (Suitable formula: Siwu Tang.) The pulse manifests on the left because the Left Heart governs blood, the Liver stores blood, and the Kidneys govern fluids, serving as the source of blood. The head models Heaven and is the head of all Yang meridians. It is also said that Clear Yang emerges from the upper orifices, with the eyes among them. Clear Yang refers to Qi. If Qi is insufficient, it cannot ascend, leading to emptiness in the head and eyes, causing frequent vertigo. The pulse on the right hand must be large but forceless, presenting a scattered and loose image; this can also be called Qi-deficiency vertigo. The pulse manifests on the right because the Right Lung governs Qi, the Spleen generates Qi, and the Mingmen Fire is the root of Qi. (Suitable formulas include Buzhong Yiqi Tang [Tonify the Middle and Augment the Qi Decoction], Chuanxiong [Ligusticum Rhizome], Danggui [Angelicae Sinensis Radix], and Juhua [Chrysanthemi Flos].)