大凡头痛属三阳，乃邪气上攻也。太阳专主头痛，阳明、少阳亦有之。三阴络上不过头，惟厥
阴循喉咙之后，上连目，系顶巅，故有头痛干呕，吐涎沫之证，却无身热，亦与阳证不同。虽然，
风湿在少阴，湿温在太阴，其经从足走至胸中而还，及头痛过于阴毒，是又不可拘也。若两感于寒，
太阳、少阴俱病，则头痛口干，烦
满而渴，与夫头痛极甚，又连于胸，手足寒者，则为真头痛，不可治矣。
太阳病，头痛发热，恶寒无汗，麻黄汤；有汗，桂枝汤。已发汗，未发汗，头痛如破者，葛根
葱白汤。太阳病，下之，脉细数者，头痛未止，连须葱白汤。
阳明头痛，不恶寒反恶热，六七日不大便，胃实，气攻于上也，少与调胃承气汤。少阳头痛，
脉弦，发热，小柴胡汤。
湿家头痛，鼻塞，瓜蒂末纳鼻中，黄水出立愈。痰涎头痛，胸满寒热，脉紧，瓜蒂散吐之。
厥阴头痛，干呕吐涎沫，吴茱萸汤。头痛，壮热心烦，栀子黄芩汤。天行、劳复头痛，四肢痛，
葱头汤。
项背强者，太阳表邪也，发散则解。结胸项强，有下之证。寒湿项强，则成 ，见本条，临病
宜审。
太阳病，项强，无汗恶风，为表实，葛根汤；项背强，发热，汗出恶风，为表虚，桂枝加葛根。
误下太阴，结胸，项强，大陷胸丸。一法频与理中丸。若损甚者，兼与四逆汤。
项强，胁下满，身热恶风，手足温而渴，小柴胡汤。
阴毒，初得病，项背强，咽痛，心腹痛，短气，厥逆吐利，身如被杖，附子汤、阴毒甘草汤、
正阳汤。天明复作热，至晚则腰痛，头项强，身重，葛根生姜豉汤。
大凡头痛归属于三阳经，这是邪气向上攻冲所致。太阳经专门主管头痛，阳明经和少阳经也会出现头痛。三阴经的络脉上行不过头部，只有厥阴经循行经过喉咙后方，向上连接眼睛，系连头顶，所以会出现头痛、干呕、吐涎沫的症状，却没有身体发热，这与阳证不同。虽然如此，风湿之邪在少阴经，湿温之邪在太阴经，其经脉从足部走向胸部然后返回，以及头痛严重到如同阴毒证那样，又是不可拘泥于上述说法的。如果两感于寒（太阳与少阴同时受邪），太阳经和少阴经都发病，则出现头痛、口干、烦闷而渴，以及头痛极其剧烈，又牵连到胸部，手足寒冷的情况，这就称为真头痛，是无法治疗的。
太阳病，表现为头痛、发热、恶寒、无汗，用麻黄汤治疗；如果有汗，用桂枝汤治疗。无论已经发过汗还是没有发过汗，只要头痛剧烈如要破裂一样，用葛根葱白汤治疗。太阳病，误用下法后，脉象细数，头痛仍未停止，用连须葱白汤治疗。
阳明经头痛，不恶寒反而恶热，六七天不大便，胃中实热，气机上逆攻冲头部，少量给予调胃承气汤治疗。少阳经头痛，脉象弦，发热，用小柴胡汤治疗。
患有湿病的患者出现头痛、鼻塞，将瓜蒂研成末纳入鼻中，流出黄水后立即痊愈。痰涎引起的头痛，伴有胸满、寒热往来、脉紧，用瓜蒂散催吐治疗。
厥阴经头痛，表现为干呕、吐涎沫，用吴茱萸汤治疗。头痛、高热、心烦，用栀子黄芩汤治疗。时行感冒或劳复引起的头痛，伴有四肢疼痛，用葱头汤治疗。
项背强直，是太阳经表邪所致，发散表邪即可解除。结胸证导致的项强，有可以使用下法的指征。寒湿导致的项强，会形成某种病症（原文此处似有缺字或特定指代，依文意理解为寒湿痹阻），见本条相关论述，临证时应仔细审察。
太阳病，项强、无汗、恶风，属于表实证，用葛根汤治疗；项背强直、发热、汗出、恶风，属于表虚证，用桂枝加葛根汤治疗。误下导致太阴病并出现结胸、项强，用大陷胸丸治疗。另一种方法是频繁给予理中丸。如果损伤严重者，兼用四逆汤治疗。
项强、胁下胀满、身热、恶风、手足温暖而口渴，用小柴胡汤治疗。
阴毒证，刚得病时，项背强直、咽痛、心腹痛、短气、四肢厥冷、呕吐泄泻、身体像被棍棒打过一样疼痛，用附子汤、阴毒甘草汤、正阳汤治疗。天亮时再次发作发热，到了晚上则腰痛、头项强直、身体沉重，用葛根生姜豉汤治疗。
Generally, headache belongs to the Three Yang meridians, caused by pathogenic factors attacking upwards. The Taiyang meridian specifically governs headache, while the Yangming and Shaoyang meridians also present with it. The collaterals of the Three Yin meridians do not ascend beyond the head; only the Jueyin meridian circulates behind the throat, ascends to connect with the eyes, and attaches to the vertex. Therefore, symptoms such as headache, dry retching, and vomiting of saliva occur, but without fever, which differs from Yang syndromes. Nevertheless, wind-dampness in the Shaoyin meridian and damp-warmth in the Taiyin meridian follow pathways from the foot to the chest and then return. Furthermore, headaches severe enough to resemble Yin toxicity cannot be rigidly confined to these rules. If affected by cold simultaneously (Taiyang and Shaoyin both diseased), symptoms include headache, dry mouth, irritability, fullness, and thirst. If the headache is extremely severe, radiating to the chest, accompanied by cold hands and feet, it is termed "True Headache" (Zhen Tou Tong) and is incurable.
For Taiyang disease presenting with headache, fever, aversion to cold, and anhidrosis, use Mahuang Tang (Ephedra Decoction); if there is sweating, use Guizhi Tang (Cinnamon Twig Decoction). Regardless of whether diaphoresis has already been induced or not, if the headache is excruciating as if the head were splitting, use Gegen Congbai Tang (Kudzu and Scallion White Decoction). For Taiyang disease where purgation was mistakenly applied, resulting in a fine and rapid pulse with persistent headache, use Lianxu Congbai Tang (Scallion White with Roots Decoction).
Yangming headache presents with no aversion to cold but rather aversion to heat, constipation for six or seven days, stomach excess, and qi attacking upwards; administer a small dose of Tiaowei Chengqi Tang (Regulate the Stomach and Order the Qi Decoction). Shaoyang headache presents with a wiry pulse and fever; treat with Xiaochaihu Tang (Minor Bupleurum Decoction).
In patients with dampness suffering from headache and nasal congestion, insert powder of Gengdi (Seed of Melon) into the nose; yellow fluid discharge leads to immediate cure. For headache caused by phlegm-fluid retention, accompanied by chest fullness, alternating chills and fever, and a tight pulse, induce vomiting using Gengdi San (Gengdi Powder).
Jueyin headache characterized by dry retching and vomiting of saliva is treated with Wuzhuyu Tang (Evodia Decoction). Headache with high fever and irritability is treated with Zhizi Huangqin Tang (Gardenia and Scutellaria Decoction). Headache due to epidemic pathogens or relapse after exertion, accompanied by limb pain, is treated with Congtou Tang (Scallion Head Decoction).
Stiffness of the neck and back is due to exterior pathogenic factors of the Taiyang meridian; resolving the exterior will alleviate it. Neck stiffness associated with Chest Binding (Jie Xiong) indicates indications for purgation. Neck stiffness due to cold-dampness leads to specific manifestations (refer to the relevant section); clinical judgment is required.
For Taiyang disease with neck stiffness, anhidrosis, and aversion to wind, indicating Exterior Excess, use Gegen Tang (Kudzu Decoction). For neck stiffness with fever, sweating, and aversion to wind, indicating Exterior Deficiency, use Guizhi Jia Gegen Tang (Cinnamon Twig Decoction plus Kudzu). If mistaken purgation leads to Taiyang disease complicated by Chest Binding and neck stiffness, use Daxiexion Wan (Major Xiexion Pill). Alternatively, frequently administer Lizhong Wan (Regulate the Middle Pill). If damage is severe, combine with Sini Tang (Frigid Extremities Decoction).
Neck stiffness with hypochondriac fullness, fever, aversion to wind, warm hands and feet, and thirst is treated with Xiaochaihu Tang (Minor Bupleurum Decoction).
Yin Toxicity initially presents with neck stiffness, sore throat, heart and abdominal pain, shortness of breath, cold extremities, vomiting and diarrhea, and body pain resembling being beaten with a stick; treat with Fuzi Tang (Aconite Decoction), Yindu Gancao Tang (Yin Toxicity Licorice Decoction), or Zhengyang Tang (Upright Yang Decoction). If fever recurs at dawn, followed by night-time lower back pain, neck stiffness, and heaviness of the body, use Gegen Shengjiang Chi Tang (Kudzu, Ginger, and Fermented Soybean Decoction).