〔大〕妇人头眩，由气虚风入于脑，循脉引于目系，目系急而然也。邪甚则必癫。
《素问》云∶头痛癫疾，下虚上实，过在足少阴、巨阳，甚则入肾。徇蒙招摇，目瞑耳聋；
下实上虚，过在足少阳、厥阴，甚则在肝。下虚者，肾虚也，故肾厥则头痛；上虚者，肝
虚也，故肝虚则晕。徇蒙者，如以物蒙其首，招摇不定，目眩耳聋，皆晕之状，故肝厥头
痛不同也。
〔薛〕丹溪先生云∶眩者言其黑运旋转，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。若风则有汗，寒则掣痛，暑则热闷，湿
则重滞，此四气乘虚而眩晕也。若郁结生痰而眩晕者，此七情虚火上逆也。若淫欲过度
而眩晕者，此肾虚气不归源也。若吐衄漏崩而眩晕者，此肝虚不能摄血也。有早起眩晕，
须臾自定者，元气虚也，正元饮（杂病自汗。）下黑锡丹。（杂病头痛。）伤湿头晕，用肾着汤（杂病
伤湿。）加川芎。有痰，用青州白丸子。（杂病中风。）头风，风热也，久则目昏。偏头风相火也，
久则目紧便涩。皆宜出血以开表之。窃谓前证肝虚头晕，用钓藤散。肾虚头晕，六味丸。
（杂病虚劳。）头晕吐痰，养正丹；不应，八味丸。（杂病虚劳。）血虚，四物、参、苓、白术；不应，
当归补血汤。（杂病劳倦。）气虚，四君、归、 ；不应，补中益气汤。（杂病劳倦。）肝木实，泻青
丸。（杂病头痛。）虚用地黄丸。（杂病虚劳。）不应，川芎散。脾气虚，二陈、参、术、柴胡、升
麻；不应，益气汤加茯苓、半夏。脾胃有痰，半夏白术天麻汤。风痰上涌，四神散。发热
恶寒，八物汤。（杂病虚劳。）七情气逆，四七汤。伤湿而晕，除湿汤。（杂病中湿。）一妇素头晕，
不时而作，月经迟而少，此中气虚弱，不能上升而头晕，不能下化而经少。用补中益气
汤而愈。后因劳仆地，月经如涌，此劳伤火动，用前汤加五味子，一剂而愈。前证虽云
气无所附，实因脾胃亏损耳。一妇人内热口干，劳则头晕、吐痰、带下。详下嘈杂门。
养正丹 治虚风头眩，吐涎不已。盖此药升降阴阳，补接真气，非止头眩而已。
黑铅 水银 硫黄（研） 朱砂（研，各一两）
上用建盏一只，火上熔铅成汁，次下水银，用柳杖子打停，取下歇少时，入二味打
停，候冷取下，研为粉，以糯米软饭丸如绿豆大。每服三十丸，枣汤吞下，空心食前，日
二服。
钓藤散 （《本事》）治肝厥头晕。清头目。
钓藤 陈皮（去白） 半夏（汤洗七次，切片子） 麦门冬（去心） 茯苓（去皮） 茯神（去木）
人参（去芦） 甘菊花 防风（去芦，各半两） 甘草（二钱半，炙） 石膏（一两）
上 咀，每服四钱，水一盏半，生姜七
片，煎至一盏，去滓热服，日进二服。
独活散 治妇人风眩，头疼呕逆，身体时痛，情思昏闷。
独活（一两） 白术（去芦） 防风（去芦） 细辛（去苗） 人参（去芦） 芎 荆芥（各七钱半）
半夏（汤洗七次，切片子） 炙甘草 赤芍药（各半两） 石膏（二两）
上 咀，每服八钱，水一中盏半，生姜七片，薄荷七叶，煎至一大盏，去滓温服，不拘时。
川芎散 治风眩头晕。
川芎 山药 白茯神（去木） 甘菊花（野菊不用） 人参（各半两，去芦） 山茱萸肉（一两）
上为细末，每服二钱，温酒调下，不拘时候，日进三服。
四神散 治妇人血风，眩晕头痛。
菊花 当归（去芦） 旋复花 荆芥穗（各等分）
上为细末，每服二钱，水一盏，葱白三寸，茶末一钱，煎至七分，通口服，良久，去枕仰卧少时。
《斗门方》 治血风头旋，或不知人事。
用喝起草嫩心阴干为末，酒服二钱，其功甚效。即前苍耳散。
治头旋如天动地转，名曰心眩。
胆矾一两，细研，用面饼剂一个拌匀，勒如骰子大，瓦上焙干。每服一骰，为末，灯心、竹
茹煎汤调下。此去痰之法，当审而用之。
【大论】妇女出现头晕，是由于气虚导致风邪侵入脑部，沿着经脉牵引至目系（眼球后连于脑的脉络），致使目系拘急而引发。若邪气严重，则必然发展为癫疾。
《素问》说：头痛和癫疾，属于下虚上实的病机，病变在于足少阴肾经和足太阳膀胱经，严重时病邪深入肾脏。出现视物模糊、摇晃不定、闭眼昏黑、耳聋等症状；若是下实上虚，病变在于足少阳胆经和足厥阴肝经，严重时病在肝脏。所谓下虚，是指肾虚，所以肾气厥逆会导致头痛；所谓上虚，是指肝虚，所以肝气虚弱会导致眩晕。徇蒙（形容头目昏沉如被物蒙蔽），招摇不定，目眩耳聋，都是眩晕的表现，因此与肝厥引起的头痛有所不同。
【薛己按语】丹溪先生曾说：眩晕是指眼前发黑、旋转的感觉，症状表现为闭眼昏暗，身体转动时感到耳聋，如同站在船或车上一样，站起时想要跌倒。这大多是因为极度虚弱又感受寒邪所致，治疗也不能仅凭一种方法。如果是风邪引起的，会有汗出；寒邪引起的，会有掣痛（牵拉性疼痛）；暑邪引起的，会有热闷感；湿邪引起的，会有沉重滞涩感，这是四种外邪乘虚侵袭导致的眩晕。如果是因情志郁结生痰而导致的眩晕，这是七情内伤、虚火上逆所致。如果是因房事过度而导致的眩晕，这是肾虚、气不归元所致。如果是因吐血、鼻衄、漏下、崩中失血而导致的眩晕，这是肝虚不能统摄血液所致。有早晨起床时眩晕，片刻后自行缓解的，这是元气虚弱，可用正元饮（见杂病自汗门），并服用黑锡丹（见杂病头痛门）。伤湿引起的头晕，用肾着汤（见杂病伤湿门）加川芎。有痰者，用青州白丸子（见杂病中风门）。头风，属风热，日久会导致视力昏花。偏头风，属相火，日久会导致眼部紧绷、大便干涩。这些情况都适宜通过放血来开泄表邪。我认为前述证候中，肝虚头晕，用钓藤散。肾虚头晕，用六味丸（见杂病虚劳门）。头晕伴吐痰，用养正丹；若无效，用八味丸（见杂病虚劳门）。血虚，用四物汤加人参、茯苓、白术；若无效，用当归补血汤（见杂病劳倦门）。气虚，用四君子汤加当归；若无效，用补中益气汤（见杂病劳倦门）。肝木实证，用泻青丸（见杂病头痛门）。虚证用地黄丸（见杂病虚劳门）；若无效，用川芎散。脾气虚，用二陈汤加人参、白术、柴胡、升麻；若无效，用益气汤加茯苓、半夏。脾胃有痰，用半夏白术天麻汤。风痰上涌，用四神散。发热恶寒，用八物汤（见杂病虚劳门）。七情气逆，用四七汤。伤湿而晕，用除湿汤（见杂病中湿门）。有一位妇人平素经常头晕，不时发作，月经推迟且量少，这是中气虚弱，不能上升滋养头部而致头晕，不能下行化生经血而致经少。服用补中益气汤后痊愈。后来因劳累仆倒在地，月经量突然增多如涌，这是劳累损伤导致相火妄动，用前方加五味子，一剂即愈。前述证候虽然说是气无所依附，实际上是因为脾胃亏损所致。另一位妇人内热口干，劳累时头晕、吐痰、带下。详见嘈杂门。
养正丹 治疗虚风头眩，涎沫不止。此药能升降阴阳，补接真气，不仅仅治疗头眩。
黑铅、水银、硫黄（研细）、朱砂（研细，各一两）
以上药物，取一只建盏，在火上熔化黑铅成汁，接着加入水银，用柳枝搅拌至均匀，取下放置片刻，再加入硫黄和朱砂搅拌至均匀，待冷却后取下，研磨成粉，用糯米软饭制成如绿豆大小的丸药。每次服用三十丸，枣汤送服，空腹食前服用，每日两次。
钓藤散 （出自《本事方》）治疗肝厥头晕。清利头目。
钓藤、陈皮（去白）、半夏（汤洗七次，切片）、麦门冬（去心）、茯苓（去皮）、茯神（去木）、人参（去芦）、甘菊花、防风（去芦，各半两）、甘草（二钱半，炙）、石膏（一两）
以上药物捣碎，每次服用四钱，加水一盏半，生姜七片，煎至一盏，去渣热服，每日进服两次。
独活散 治疗妇人风眩，头痛呕吐，身体时而疼痛，神情昏闷。
独活（一两）、白术（去芦）、防风（去芦）、细辛（去苗）、人参（去芦）、川芎、荆芥（各七钱半）、半夏（汤洗七次，切片）、炙甘草、赤芍药（各半两）、石膏（二两）
以上药物捣碎，每次服用八钱，加水一盏半，生姜七片，薄荷七叶，煎至一大盏，去渣温服，不拘时间。
川芎散 治疗风眩头晕。
川芎、山药、白茯神（去木）、甘菊花（不用野菊）、人参（各半两，去芦）、山茱萸肉（一两）
以上药物研为细末，每次服用二钱，温酒调服，不拘时候，每日进服三次。
四神散 治疗妇人血风，眩晕头痛。
菊花、当归（去芦）、旋复花、荆芥穗（各等分）
以上药物研为细末，每次服用二钱，加水一盏，葱白三寸，茶末一钱，煎至七分，通口服，过一会儿，去掉枕头仰卧片刻。
《斗门方》 治疗血风头旋，或不知人事。
用喝起草（嫩心阴干研末），酒服二钱，功效甚佳。即前面的苍耳散。
治头旋如天动地转，名为心眩。
胆矾一两，细研，用一个面饼剂拌匀，捏成骰子大小，在瓦上焙干。每次服用一个骰子大的量，研末，用灯心草、竹茹煎汤调服。这是祛痰的方法，应当审慎使用。
[Da Lun] When women experience dizziness, it is caused by Qi deficiency allowing Wind pathogen to invade the brain. The pathogen follows the meridians to draw upon the Eye System (the connective tissue linking the eyeball to the brain), causing tension in the Eye System, which results in dizziness. If the pathogenic factor is severe, it will inevitably develop into Dian disease (epilepsy or manic psychosis).
The *Suwen* states: Headache and Dian disease are characterized by deficiency below and excess above, with the pathology lying in the Foot Shaoyin Kidney Meridian and Foot Taiyang Bladder Meridian; if severe, the pathogen enters the Kidney. Symptoms include visual blurring, swaying instability, closing eyes with darkness, and deafness. If there is excess below and deficiency above, the pathology lies in the Foot Shaoyang Gallbladder Meridian and Foot Jueyin Liver Meridian; if severe, the pathology is in the Liver. "Deficiency below" refers to Kidney deficiency, therefore Kidney Qi reversal causes headache; "deficiency above" refers to Liver deficiency, therefore Liver Qi deficiency causes dizziness. "Xunmeng" describes a sensation as if the head were covered by an object, accompanied by swaying instability, visual dizziness, and deafness—all manifestations of vertigo. Thus, this differs from headache caused by Liver Qi reversal.
[Xue Ji's Commentary] Master Danxi stated: Dizziness refers to a sensation of blackness and rotation, presenting with closed eyes and dim vision, body movement accompanied by deafness, feeling as if standing on a boat or ship, and a desire to fall when rising. This is generally caused by extreme deficiency combined with Cold invasion. Treatment cannot follow a single rigid method. If caused by Wind, there will be sweating; if by Cold, there will be pulling pain; if by Summerheat, there will be heat and stifling sensation; if by Dampness, there will be heaviness and stagnation. These four climatic factors cause dizziness by taking advantage of deficiency. If caused by phlegm generated from emotional constraint, this is due to upward rebellion of deficient Fire caused by the Seven Emotions. If caused by excessive sexual indulgence, this is due to Kidney deficiency and Qi failing to return to its source. If caused by hematemesis, epistaxis, metrorrhagia, or metrostaxis leading to blood loss, this is due to Liver deficiency failing to control blood. In cases where dizziness occurs upon waking in the morning and resolves spontaneously after a moment, this is due to Yuan Qi deficiency; Zhengyuan Yin (see Miscellaneous Diseases: Spontaneous Sweating) should be used, along with Heixi Dan (see Miscellaneous Diseases: Headache). For dizziness caused by Dampness injury, Shenzhuo Tang (see Miscellaneous Diseases: Dampness Injury) added with Chuanxiong Rhizome (Chuanxiong) is used. For cases with phlegm, Qingzhou Baiwanzi (see Miscellaneous Diseases: Stroke) is used. Toufeng (Head Wind) is caused by Wind-Heat; prolonged cases lead to blurred vision. Pian Toufeng (Hemicrania) is caused by Ministerial Fire; prolonged cases lead to tightness of the eyes and dry stool. All these conditions are suitable for treatment via bloodletting to release the exterior. I believe that for the aforementioned syndromes, Liver deficiency causing dizziness should be treated with Diaoteng San. Kidney deficiency causing dizziness should be treated with Liuwei Wan (see Miscellaneous Diseases: Deficiency Labor). Dizziness with expectoration of phlegm should be treated with Yangzheng Dan; if ineffective, Bawei Wan (see Miscellaneous Diseases: Deficiency Labor) is used. Blood deficiency is treated with Siwu Decoction added with Ginseng Radix et Rhizoma (Renshen), Poria Cocos (Fuling), and Atractylodis Macrocephalae Rhizoma (Baizhu); if ineffective, Danggui Buxue Tang (see Miscellaneous Diseases: Fatigue and Overwork) is used. Qi deficiency is treated with Sijunzi Decoction added with Angelica Sinensis Radix (Danggui); if ineffective, Buzhong Yiqi Tang (see Miscellaneous Diseases: Fatigue and Overwork) is used. Liver Wood excess is treated with Xieqing Wan (see Miscellaneous Diseases: Headache). Deficiency is treated with Dihuang Wan (see Miscellaneous Diseases: Deficiency Labor); if ineffective, Chuanxiong San is used. Spleen Qi deficiency is treated with Erchen Decoction added with Renshen, Baizhu, Bupleuri Radix (Chaihu), and Cimicifugae Rhizoma (Shengma); if ineffective, Yiqi Tang added with Fuling and Pinelliae Tuber (Banxia) is used. Phlegm in the Spleen and Stomach is treated with Banxia Baizhu Tianma Tang. Wind-phlegm surging upward is treated with Sishen San. Fever and aversion to cold are treated with Bawu Tang (see Miscellaneous Diseases: Deficiency Labor). Rebellious Qi due to the Seven Emotions is treated with Siquan Tang. Dizziness due to Dampness injury is treated with Chushi Tang (see Miscellaneous Diseases: Invasion by Dampness).
A woman who habitually suffered from dizziness, occurring intermittently, with delayed and scant menstruation, was diagnosed with Middle Qi deficiency unable to ascend to nourish the head (causing dizziness) and unable to descend to transform into menstrual blood (causing scant flow). She was cured using Buzhong Yiqi Tang. Later, due to fatigue and falling to the ground, her menstruation became profuse like a gush. This was due to labor injuring the body and stirring up Fire. The previous formula was used with added Schisandrae Fructus (Wuweizi), and she was cured after one dose. Although the aforementioned syndrome is described as Qi having no attachment, it is essentially due to damage of the Spleen and Stomach. Another woman presented with internal heat, dry mouth, dizziness upon exertion, expectoration of phlegm, and leukorrhea. See the section on Zao Re (Gastric Discomfort/Hunger Pain).
Yangzheng Dan treats deficiency-type Wind causing dizziness and incessant salivation. This medicine regulates the ascending and descending of Yin and Yang, supplements and connects True Qi, and does more than just treat dizziness.
Ingredients: Leadum Nigrum (Heiqian), Mercury (Shuiyin), Sulfur (Liuhuang, pounded), Cinnabar (Zhusha, pounded, each 1 liang).
Preparation: Take one Jian ware bowl. Melt the Leadum Nigrum over fire until liquid. Then add Mercury, stirring with a willow branch until uniform. Remove from heat and let rest briefly. Add Sulfur and Cinnabar, stirring until uniform. Allow to cool, remove, and grind into powder. Mix with soft glutinous rice paste to form pills the size of mung beans. Dosage: 30 pills per administration, swallowed with jujube decoction, taken on an empty stomach before meals, twice daily.
Diaoteng San (from *Benshi Fang*) treats Liver Jue causing dizziness. Clears the head and eyes.
Ingredients: Uncariae Ramulus cum Uncis (Diaoteng), Citri Reticulatae Pericarpium (Chenpi, white part removed), Pinelliae Tuber (Banxia, washed seven times in boiling water, sliced), Ophiopogonis Tuber (Maimendong, heart removed), Poria Cocos (Fuling, peel removed), Poria Cum Radice Xyli (Fushen, woody core removed), Ginseng Radix et Rhizoma (Renshen, radix removed), Chrysanthemi Flos (Gan Juhua), Saposhnikoviae Radix (Fangfeng, radix removed, each half liang), Glycyrrhizae Radix et Rhizoma (Gancao, 2 qian 5 fen, honey-fried), Gypsum Fibrosum (Shigao, 1 liang).
Preparation: Coarsely crush the herbs. For each dose, use 4 qian. Add 1.5 sheng of water and 7 slices of Zingiberis Rhizoma Recens (Shengjiang). Decoct until 1 sheng remains. Strain and take hot. Administer twice daily.
Duhuo San treats Wind vertigo in women, accompanied by headache, vomiting, intermittent body pain, and mental confusion.
Ingredients: Angelicae Pubescentis Radix (Duhuo, 1 liang), Atractylodis Macrocephalae Rhizoma (Baizhu, radix removed), Saposhnikoviae Radix (Fangfeng, radix removed), Asari Radix et Rhizoma (Xixin, leaves removed), Ginseng Radix et Rhizoma (Renshen, radix removed), Ligustici Chuanxiong Rhizoma (Chuanxiong), Schizonepetae Spica (Jingjie, each 7 qian 5 fen), Pinelliae Tuber (Banxia, washed seven times in boiling water, sliced), Honey-fried Glycyrrhizae Radix et Rhizoma (Zhi Gancao), Paeoniae Radix Rubra (Chishaoyao, each half liang), Gypsum Fibrosum (Shigao, 2 liang).
Preparation: Coarsely crush the herbs. For each dose, use 8 qian. Add 1.5 sheng of water, 7 slices of Shengjiang, and 7 leaves of Menthae Haplocalycis Herba (Bohe). Decoct until 1 large sheng remains. Strain and take warm. Take at any time.
Chuanxiong San treats Wind vertigo and dizziness.
Ingredients: Ligustici Chuanxiong Rhizoma (Chuanxiong), Dioscoreae Rhizoma (Shanyao), Poria Cum Radice Xyli (Baifushen, woody core removed), Chrysanthemi Flos (Gan Juhua, wild chrysanthemum not used), Ginseng Radix et Rhizoma (Renshen, each half liang, radix removed), Corni Fructus (Shanzhuyu, flesh only, 1 liang).
Preparation: Grind into fine powder. Dosage: 2 qian per administration, mixed with warm wine. Take at any time, three times daily.
Sishen San treats Blood-Wind in women, causing vertigo and headache.
Ingredients: Chrysanthemi Flos (Juhua), Angelicae Sinensis Radix (Danggui, radix removed), Inulae Flos (Xuanjinhua), Schizonepetae Spica (Jingjiesui, equal parts).
Preparation: Grind into fine powder. Dosage: 2 qian per administration. Add 1 sheng of water, 3 cun of Allii Fistulosi Bulbus (Congbai), and 1 qian of tea powder. Decoct until 70% remains. Drink through. After some time, remove the pillow and lie supine for a while.
*Doudou Fang* treats Blood-Wind causing spinning vertigo or loss of consciousness.
Take the tender hearts of Hedychium coronarium (Hecao Cao), dry them in the shade, and grind into powder. Take 2 qian with wine. The effect is very good. This is the same as the Cang'er San mentioned earlier.
To treat vertigo as if heaven moves and earth turns, named Xin Xuan (Heart Vertigo):
Alumen (Danfan, 1 liang), finely pounded. Mix evenly with one dough cake. Shape into dice-sized cubes. Roast on a tile until dry. Dosage: One cube per administration, ground into powder. Mix with decoction of Centelli Herba (Dengxincao) and Bambusae Caulis in Succo (Zhuru) and take orally. This is a method to eliminate phlegm; it must be used with caution.