痰饮头风七气失血中酒等病。皆能眩晕。已各见本证。今独举不兼他病见眩晕者。是皆
虚损也。然有不时眩者。有早起眩晕。须臾自定。日以为常者。正元饮下黑锡丹。
伤湿头晕。肾着汤加川芎名除湿汤。
有因虚致晕虽晕醒时。面常欲近火。欲得暖手按之。盖头面乃诸阳之会。阳气不足故耳
有头风证。耳内常鸣。头上有如鸟雀啾啾之声。切不可全谓耳鸣为虚。此头脑挟风所为
也。
有眩晕之甚。抬头则屋转。眼常黑花。观见常如有物飞动。或见物为两。宜小三五七散。或
芎附汤。生料正元饮。加鹿茸一钱。下灵砂丹。或用正元饮。炒川椒一十五粒。下茸朱丸。
若不效。则独用鹿茸一味。每服半两。用无灰酒三盏。煎至一盏。去滓入麝香少许服。缘鹿
茸生于头。头晕而治以鹿茸。盖以类相从也。曾有头疼痛不愈。服茸朱丹而效。
虚炎阴阳不升降。下虚上盛。气促喘急。宜苏子降气汤。去前胡。下黑锡丹。或养正丹
气
急甚而不能眠卧者。沉附汤或正元饮。或四桂散去木香用沉香。并以盐煎。下黑锡丹或灵砂
丹。三妙丹。不效。则以前药下朱砂丹。
短乏者。下气不接上。呼吸不来。语言无力。宜补虚四桂饮。木香减半。加黄 山药各
一钱
若不胜热药及痰多之人。当易熟附子作生附。在人活法。余皆仿此。药轻病重。四桂饮不
足取效。宜于本方去木香加炒川椒十五粒。更不效。则用椒附汤。上焦干燥不胜热药
者。宜于椒附汤加人参一钱。寻常病当用姜附。而或上盛燥热不可服者。惟此最良。
气短乏力之人。于进药之外。选一盛壮男子。吸自己之气。嘘入病患口中。如此数次。
亦可为药力一助。此法不特可治虚乏。寻常气暴逆致呃者。用之良验。
痰饮、头风、七气病、失血、饮酒过度等病症，都能引起眩晕。这些情况已在各自的证候章节中详细论述。现在单独列举不兼夹其他疾病而仅表现为眩晕的情况，这些都属于虚损所致。
其中有的患者不时发生眩晕；有的患者在清晨起床时眩晕，片刻后自行缓解，每日如此，成为常态。此类情况可服用正元饮，并送服黑锡丹。
有的因虚损导致眩晕，虽然眩晕清醒后，面色仍喜欢靠近火源，希望用温暖的手按压头部。这是因为头面部是诸阳经汇聚之处，阳气不足的缘故。
有的患有头风证，耳内常鸣响，头上有如同鸟雀叽叽喳喳的声音。切不可完全认为耳鸣都是虚证，这是头脑夹杂风邪所致。
有的眩晕非常严重，抬头时感觉房屋旋转，眼前经常看到黑花飞舞，看东西常有物体在飞动，或者视物成双。适宜服用小三五七散，或芎附汤、生料正元饮加鹿茸一钱，并送服灵砂丹。或者使用正元饮，配合炒川椒十五粒，送服茸朱丸。如果无效，则单独使用鹿茸一味药，每次服用半两，用无灰酒三盏，煎煮至一盏，去渣后加入少许麝香服用。因为鹿茸生于头部，治疗头晕时使用鹿茸，这是取“以类相从”的道理。曾经有头痛久治不愈的患者，服用茸朱丹而见效。
虚火上炎，阴阳之气不能正常升降，下焦虚而上焦盛，气息急促且喘息急迫，适宜服用苏子降气汤，去掉前胡，送服黑锡丹，或养正丹。
气喘严重时无法躺卧睡眠者，可用沉附汤或正元饮，或者四桂散去木香改用沉香，均用盐煎煮，送服黑锡丹、灵砂丹或三妙丹。如果无效，则用前面的药物送服朱砂丹。
呼吸短促乏力者，表现为下气不能接续上气，呼吸不畅，说话无力，适宜服用补虚四桂饮，木香用量减半，加山药各一钱。
如果不能耐受热性药物及痰多的人，应当将熟附子改为生附子，这在于医生的灵活变通，其余方剂仿照此法处理。如果药力轻而病情重，四桂饮不足以见效，宜在本方中去掉木香，加入炒川椒十五粒。如果仍然无效，则使用椒附汤。对于上焦干燥、不能耐受热性药物的人，适宜在椒附汤中加入人参一钱。通常病症应当使用姜、附类药物，但如果上焦燥热不可服用者，以此方最为良效。
对于气短乏力的人，除了进服药物的外，可选一名身体强壮的男子，吸入自己的气息，吹入患者口中。如此数次，也可以作为药力的辅助。这种方法不仅可用于治疗虚乏，对于寻常因气机暴逆导致的呃逆，使用此法也疗效显著。
Phlegm-fluid retention (Tan Yin), wind-headache (Tou Feng), seven qi disorders (Qi Qi), blood loss, and alcohol intoxication can all cause vertigo. These conditions have been discussed in their respective syndrome chapters. Here, we specifically address cases of vertigo occurring without accompanying other diseases, which are all attributed to deficiency and damage (Xu Sun).
Some patients experience intermittent vertigo; others suffer from vertigo upon rising in the morning, which subsides after a short while and becomes a daily routine. For such cases, Zhengyuan Yin (Upright Origin Decoction) should be administered, followed by Heixi Dan (Black Tin Pill).
For dizziness caused by dampness invasion, Shenzhuo Tang (Kidney-Dampness Decoction) with added Chuanxiong Rhizome (Chuanxiong) is named Chushi Tang (Dampness-Removing Decoction).
In cases where vertigo results from deficiency, even after the vertigo subsides, the patient's face often desires proximity to fire, and they wish for warm hands to press upon the head. This is because the head and face are the confluence of all yang meridians, and insufficient yang qi is the cause.
Patients with wind-headache syndrome may experience constant tinnitus and a buzzing sound in the head, like birds chirping. One must not assume that tinnitus is solely due to deficiency; this is caused by wind pathogen affecting the head and brain.
In severe cases of vertigo, looking up causes the sensation of the room spinning, dark spots frequently appear before the eyes, objects seem to fly or move, or diplopia (double vision) occurs. Xiaosanwuqi San (Minor Three-Five-Seven Powder), Xiongfu Tang (Ligusticum and Aconite Decoction), or Shengliao Zhengyuan Yin (Unprocessed Zhengyuan Decoction) with one qian of Deer Antler (Lurong) are suitable, followed by Lingsha Dan (Cinnabar and Mercury Pill). Alternatively, Zhengyuan Yin with fifteen grains of fried Sichuan peppercorn (Chuanjiao) may be used, followed by Rongzhu Wan (Antler and Cinnabar Pill). If ineffective, use only Deer Antler (Lurong), half liang per dose, decocted in three cups of unadulterated wine until reduced to one cup. Strain and add a small amount of Moschus (Shexiang). Since deer antler grows on the head, using it for vertigo follows the principle of "similar things attract." There was a case of persistent headache cured by Rongzhu Dan.
When deficient fire flares upward, causing failure of yin and yang to ascend and descend properly, with lower deficiency and upper excess, leading to rapid breathing and acute asthma, Suzi Jiangqi Tang (Perilla Seed Descending Qi Decoction) without Qianhu, followed by Heixi Dan or Yangzheng Dan, is indicated.
If asthma is severe enough to prevent lying down and sleeping, Chenfu Tang or Zhengyuan Yin may be used. Alternatively, Sigui Tang without Muxiang but with Chenxiang, boiled with salt, followed by Heixi Dan, Lingsha Dan, or Sanmiao Dan. If ineffective, administer Zhusha Dan with the aforementioned decoctions.
For shortness of breath and fatigue, where lower qi fails to connect with upper qi, breathing is difficult, and speech is weak, Buxu Sigui Yin (Deficiency-Nourishing Four-Ginger Decoction) with half the dosage of Muxiang and one qian each of Huangqi and Dioscorea Rhizome (Shanyao) is suitable.
For those who cannot tolerate hot medicines or have excessive phlegm, prepared Aconite Root (Fuzi) should be replaced with raw Aconite Root. This requires clinical flexibility; other formulas follow this pattern. If the medication is too mild for the severity of the disease, Sigui Yin may be insufficient. In such cases, remove Muxiang from the base formula and add fifteen fried Sichuan peppercorns (Chuanjiao). If still ineffective, use Jiaofu Tang (Peppercorn and Aconite Decoction). For patients with upper jiao dryness who cannot tolerate hot medicines, add one qian of Ginseng Radix et Rhizoma (Renshen) to Jiaofu Tang. While ginger and aconite are typically used, if upper jiao dryness-heat precludes their use, this formula is most effective.
For individuals with shortness of breath and fatigue, besides administering medicine, select a robust male to inhale his own breath and exhale it into the patient's mouth several times. This can assist the medicinal effect. This method is not only effective for deficiency and fatigue but also highly efficacious for hiccups caused by sudden rebellious qi.