This paper presents a complete theoretical framework for studying turbulence and transport in rapidly rotating tokamak plasmas. The fundamental scale separations present in plasma turbulence are codified as an asymptotic expansion in the ratio ε = ρi/α of the gyroradius to the equilibrium scale length. Proceeding order by order in this expansion, a set of coupled multiscale equations is developed. They describe an instantaneous equilibrium, the fluctuations driven by gradients in the equilibrium quantities, and the transport-timescale evolution of mean profiles of these quantities driven by the interplay between the equilibrium and the fluctuations. The equilibrium distribution functions are local Maxwellians with each flux surface rotating toroidally as a rigid body. The magnetic equilibrium is obtained from the generalized Grad-Shafranov equation for a rotating plasma, determining the magnetic flux function from the mean pressure and velocity profiles of the plasma. The slow (resistive-timescale) evolution of the magnetic field is given by an evolution equation for the safety factor q. Large-scale deviations of the distribution function from a Maxwellian are given by neoclassical theory. The fluctuations are determined by the 'high-flow' gyrokinetic equation, from which we derive the governing principle for gyrokinetic turbulence in tokamaks: the conservation and local (in space) cascade of the free energy of the fluctuations (i.e. there is no turbulence spreading). Transport equations for the evolution of the mean density, temperature and flow velocity profiles are derived. These transport equations show how the neoclassical and fluctuating corrections to the equilibrium Maxwellian act back upon the mean profiles through fluxes and heating. The energy and entropy conservation laws for the mean profiles are derived from the transport equations. Total energy, thermal, kinetic and magnetic, is conserved and there is no net turbulent heating. Entropy is produced by the action of fluxes flattening gradients, Ohmic heating and the equilibration of interspecies temperature differences. This equilibration is found to include both turbulent and collisional contributions. Finally, this framework is condensed, in the low-Mach-number limit, to a more concise set of equations suitable for numerical implementation.