## Spinning, light-headed, or unsteady
Dizziness is one word for several different experiences. The room spinning when you roll over in bed. A grey-out when you stand up too fast. A floating, unsteady feeling that never quite goes away. A swimming head before a meeting or a hard conversation. It may have been called vertigo, BPPV, low blood pressure, or "just stress," and some of those names are exactly right. What they don't always explain is why it keeps coming back, or why it comes with heaviness, nausea, or fatigue.
The Donguibogam, the 1613 master text, treats dizziness inside its chapter on the head, in seven sections of its own. It names six kinds — from wind, heat, phlegm, emotion, depletion, and damp — and describes each by the details a patient would notice. We translated it in full.
[→ The Head — full translated chapter]
## Full above, empty below
The chapter's summary of all dizziness is a single phrase: fullness above with emptiness below. What is lacking is Qi and Blood — the support that should rise to the head. What is in excess is phlegm, wind, and fire — the things that rise to the head when they shouldn't. Most dizziness is some mix of the two, and treatment depends on which side dominates.
It adds one line that has guided practitioners ever since: without phlegm, there is no dizziness. Even when wind is the cause, it says, phlegm is involved. In modern terms, that is the dizziness that comes with a heavy head, nausea, a coated tongue, and a sense of fog — the kind that often follows poor digestion, irregular meals, or long periods of exhaustion.
## The questions that sort it
**Does it come when you stand up, and pass in a moment?** The chapter describes this precisely: an older person, dizzy each morning on rising, settled again after a little while. It reads this as Yang too weak to follow the body upward — postural dizziness, four hundred years before the term.
**Does it come with heaviness, nausea, and a head too heavy to lift?** — phlegm. The chapter's fullest description of this kind belongs to its account of headache: the head splitting, the body heavy as a mountain, vomiting, the eyes unwilling to open, as though lost in wind and cloud. Where dizziness comes with palpitations, it reads the cause as fluid lodged below the heart.
**Does it follow exhaustion, illness, or heavy bleeding?** — depletion. The chapter gives separate treatment for dizziness from worn-down Qi and for dizziness after losing a great deal of blood.
**Does it come before an event — a meeting, a confrontation, a decision?** — one of the chapter's formulas is indicated exactly for this: dizziness on facing a matter, with unease and a churning stomach, read as the Heart and Spleen both timid and depleted.
**Does it follow strong emotion?** — where the seven emotions have done damage, the chapter says, Qi stagnates, phlegm forms, and dizziness follows, often with pain over the brow and eyes that won't open.
**Does it come in hot weather, with thirst and agitation?** — heat. **After being caught in the rain, with a blocked nose and heavy voice?** — damp.
## Why the neck matters
The chapter quotes the Divine Pivot on how wind causes dizziness: the eye's connection runs back to the brain and out at the nape, so an evil that strikes the back of the neck, meeting a weakened body, can follow that connection inward until the head turns and the eyes spin.
Whatever one makes of the mechanism, the observation is clinically familiar: dizziness often travels with a stiff, tight neck, and treating the neck often helps. If yours does, read more here — [Neck pain]
## The motion of a boat
The chapter also explains motion sickness, and the explanation is the same as for wind dizziness: two movements meeting. Wind governs movement; when the body's own internal wind is stirred and the outside world is moving too — on a boat, in a cart, dancing in a ring — the head and eyes turn. People whose dizziness is set off by cars, boats, or crowded moving spaces are often the same people whose internal pattern is already unsettled.
## What treatment looks like here
Acupuncture is the main tool. The chapter gives a long list of points for dizziness, concentrated along the midline of the head — GV24 Shenting, GV23 Shangxing, GV21 Qianding, GV19 Houding — and at the base of the skull, GB20 Fengchi, with distal points on the hands and feet and ST36 Zusanli below the knee. For dizziness with a dread of cold — the patient who wears a hat even in summer and becomes dizzy the moment it comes off — it uses GV20 Baihui, GV23 Shangxing, GB20 Fengchi, and ST40 Fenglong, the classic point for phlegm.
Herbal formulas follow the kind of dizziness. From the chapter:
[Banhabaekchulcheonma-tang 半夏白朮天麻湯] — for dizziness with heaviness, nausea, and a foggy head
[Taeksa-tang 澤瀉湯] — for dizziness with palpitations, from fluid lodged below the heart
[Cheongunhwadam-tang 淸暈化痰湯] — for dizziness from phlegm and heat together
[Bojungikgi-tang 補中益氣湯] — for dizziness from exhaustion and worn-down Qi
[Jaeumgeonbi-tang 滋陰健脾湯] — for dizziness with unease before events, from a depleted Heart and Spleen
[Sipjeondaebo-tang 十全大補湯] — for dizziness with deep depletion, especially in older patients
[Gungchul-tang 芎朮湯] — for dizziness after being caught in the rain, with a heavy head and blocked nose
Recurring dizziness often improves within a few weeks of treatment. Long-standing patterns, especially those tied to depletion or poor digestion, usually take longer.
## Please read this part
Dizziness is one of the symptoms where a physician should rule things out first.
**Get emergency care if you have:** dizziness with sudden weakness or numbness on one side, facial drooping, slurred speech, double vision, or trouble walking; a sudden severe headache; fainting, or nearly fainting, with chest pain, palpitations, or shortness of breath; dizziness after a head injury; or dizziness with black stools, vomiting blood, or heavy bleeding.
**Get evaluated before starting here if you have:** episodes of spinning with hearing loss or ringing in one ear; spinning that comes on when you turn over in bed or look up, which a physician or physical therapist can often treat directly with a simple repositioning maneuver; dizziness that began with a new medication; repeated falls; or dizziness that is constant and getting worse.
The 1613 chapter draws the same line, and bluntly. Its first warning about dizziness is that it is "wind strike coming on by degrees" — what we would now call the warning signs of a stroke. It also treats dizziness after heavy blood loss as its own category. Both remain reasons to be examined before anything else.
**This approach may help if you're dealing with:** recurring dizziness once serious causes are ruled out · light-headedness on standing · a foggy, heavy head with nausea · dizziness with neck stiffness · dizziness that comes with stress or anxiety · motion sickness · dizziness after illness or exhaustion · residual unsteadiness after vertigo has been treated.
The Donguibogam translation project at formulas.raahacupuncture.com is researched and translated by Eui Young (Justin) Chung, L.Ac., Dipl. O.M. — the same clinician you'll see in the treatment room.