Guided by the theory of turbid pathogen disturbing clarity, this paper holds that the pathogenesis of otolith disorders involves the failure of clear yang to ascend and the internal generation of phlegm-turbidity as the initiating factors. The clinical manifestations are characterized by the intermingling of phlegm and fluid, as well as the disturbance between turbid and clear substances, while the root lies in spleen-kidney deficiency and depletion of primordial qi. Treatment strategies are formulated according to the different stages of the disease: in the acute phase, therapy focuses on warming and resolving phlegm-fluid retention, using a modified combination of Linggui Zhugan Decoction (苓桂术甘汤) and Zexie Decoction (泽泻汤); in the residual phase, the approach shifts to tonifying qi and uplifting clear yang, with a modified combination of Shengxian Decoction (升陷汤) and Shengmai Power (生脉散); in the consolidation phase, therapy aims to tonify the kidney and replenish essence, employing a modified version of Qiju Dihuang Pill (杞菊地黄丸).