（附目眩 摇头）
头痛属太阳证。其有头不痛而但苦眩旋者。则得之阳明者居多。凡病初起即苦头眩者。
有风
有热有痰。如经云。阳明病但头眩不恶寒。故能食而咳。其人必咽痛。阳明病以能食为中风
。是因风而头眩者也。又云。阳明病脉迟。食难用饱。饱则微烦头眩。必小便难。此欲作谷
瘅
。瘀热在里。乃发瘅黄。是因热而头眩者也。由是而推之于痰。则挟风为风痰。挟热为热痰
。凡痰必有其致痰之因。审其所因以治生痰之本。则痰自去。此皆实证立治之大法。至于少
阳
之为病则为目眩。目眩与头眩有别。而总为阳热上升之所致也。其有太阳病误施汗下。因虚
致冒而头眩者。经云。太阳病发汗。汗出不解。其人仍发热。心下悸。头眩身 动。振振欲
擗地者。真武汤主之。又伤寒若吐若下后。心下逆满。气上冲胸。起则头眩。脉沉紧。发汗
则动经。身为振振摇者。茯苓桂枝白术甘草汤主之。是虚寒之候。亟与温里补虚。犹虞不及
。
总之汗下不可误施。经云。动气在左。不可发汗。发汗则头眩。动气在右。不可下。下之则
头眩。动气在下。不可下。下之则猝起头眩。仲景早垂深戒矣。
又少阴病。下利止而头眩。时时自冒者死。诸逆发汗剧者。言乱目眩者死。此阴竭而虚
阳上
脱。不可复救。有摇头者。与头眩又有别。经云。独头面摇。卒口噤。背反张者。痉病也。
另详
痉门。更有摇头言者。里痛也。亦尚非逆候。至于阳反独留。形体如烟熏。直视摇头者。此
为心绝。必不可救。
头痛属于太阳病证。如果有头不痛只是苦于眩晕的，则大多是由于阳明经病变引起的。凡是疾病初起就苦于头晕目眩的，原因有风邪、热邪、痰饮等。如《伤寒论》经文所说：“阳明病，仅见头晕，不恶寒，因此能进食且咳嗽，患者必然咽喉疼痛。”在阳明病中，以“能进食”作为中风（风邪侵袭）的特征，这是因风邪导致头晕目眩的情况。经文又说：“阳明病，脉象迟缓，饮食难以吃饱，饱食后则轻微心烦、头晕，必然小便困难，这是将要发生谷瘅（因饮食积滞化热导致的黄疸）。瘀热蕴结在体内，从而引发黄疸。”这是因热邪导致头晕目眩的情况。由此推及痰饮，则挟带风邪的为风痰，挟带热邪的为热痰。凡是痰证必有产生痰的原因，审察其病因以治疗生痰的根本，那么痰自然消除。这都是针对实证确立的治疗大法。至于少阳病的病症则是目眩。目眩与头眩有所区别，但总归都是由于阳热之气上升所致。
如果有太阳病误用发汗或攻下法，因正气虚弱导致昏冒而头晕的，经文说：“太阳病发汗，汗出后病不解，患者仍然发热，心下悸动，头晕，身体震颤动摇，站立不稳欲倒地的，用真武汤主治。”又说：“伤寒如果经过吐法或下法治疗后，心下逆满，气上冲胸，起身时头晕，脉象沉紧，若再发汗则会扰动经络，身体震颤摇摆的，用茯苓桂枝白术甘草汤主治。”这是虚寒的证候，急需温补里虚，还担心救治不及。
总之，发汗和攻下法不可误用。经文说：“动气在左侧，不可发汗，发汗则头晕；动气在右侧，不可攻下，攻下则头晕；动气在下部，不可攻下，攻下则突然起身时头晕。”张仲景早已提出深深的告诫了。
另外，少阴病，下利停止却出现头晕，时常感到昏蒙不清的，预后不良（死证）。各种逆证剧烈发汗后，言语错乱、目眩的，也是死证。这是阴液枯竭而虚阳上浮脱失，无法再挽救。
有摇头的症状，这与头晕又有所不同。经文说：“只有头面部摇动，突然口噤不开，背部反张的，是痉病。”另详见痉病章节。还有通过摇头来表达痛苦的，这是里有疼痛，也尚不属于逆证（死证）。至于阳气反而独留，形体面色如烟熏般晦暗，直视不动且摇头的，这是心气绝灭，必定无法挽救。
(Attached: Dizziness of the Eyes, Shaking of the Head)
Headache belongs to the Taiyang syndrome. If there is no headache but only suffering from vertigo/dizziness (Touxuan), it is mostly due to Yangming disease. Whenever a disease begins with immediate dizziness/vertigo, the causes may be Wind, Heat, or Phlegm. As stated in the classic text: "In Yangming disease, if there is only dizziness/vertigo without aversion to cold, the patient can eat and cough; such a person must have a sore throat." In Yangming disease, the ability to eat indicates Wind strike (Zhongfeng, invasion by wind pathogen); this is dizziness caused by wind. The text also states: "In Yangming disease, if the pulse is slow, food cannot be taken to fullness; after eating fully, there is slight irritability and dizziness, and urination will be difficult. This is about to develop into Grain Jaundice (Gu Dan). Stagnant heat in the interior leads to jaundice." This is dizziness caused by heat. Extending this reasoning to Phlegm, phlegm combined with wind is Wind-Phlegm, and phlegm combined with heat is Heat-Phlegm. All phlegm syndromes must have a cause for their generation; examining the cause to treat the root of phlegm production will naturally eliminate the phlegm. These are the general principles for treating excess syndromes.
Regarding Shaoyang disease, the symptom is dizziness of the eyes (Muxuan). There is a distinction between dizziness of the eyes and dizziness/vertigo of the head, but both are ultimately caused by the rising of Yang-Heat.
If Taiyang disease is mistakenly treated with sweating or purging methods, leading to dizziness/vertigo due to deficiency causing mental clouding (Mao), the text says: "In Taiyang disease, after inducing sweat, if the condition does not resolve, the patient still has fever, palpitations in the epigastrium, dizziness/vertigo, body tremors, and feels as if they want to fall to the ground; Zhenwu Tang should be used." It also states: "After Shanghan (Cold Damage) is treated with emesis or purging, if there is rebellious fullness in the epigastrium, Qi rushing up to the chest, dizziness upon standing, and a deep, tight pulse, further sweating will disturb the collaterals, causing the body to tremble and sway; Ling Gui Zhu Gan Tang (Poria, Cinnamon Twig, Atractodes Macrocephala, and Licorice Decoction) should be used." This is a pattern of deficiency-cold, requiring urgent warming of the interior and tonification of deficiency, yet one might still fear that the treatment is insufficient.
In summary, sweating and purging methods must not be misapplied. The text warns: "If Dongqi (pulsating mass/sensation) is on the left, do not induce sweat; doing so causes dizziness/vertigo. If Dongqi is on the right, do not purge; doing so causes dizziness/vertigo. If Dongqi is below, do not purge; doing so causes sudden dizziness/vertigo upon rising." Zhang Zhongjing had issued these profound warnings early on.
Furthermore, in Shaoyin disease, if diarrhea stops but dizziness/vertigo occurs, accompanied by frequent episodes of mental clouding/fainting, the prognosis is fatal. If severe sweating is induced in various adverse conditions, leading to disordered speech and dizziness of the eyes, this is also a fatal sign. This represents the exhaustion of Yin fluids and the floating and detachment of deficient Yang, which cannot be rescued.
Shaking of the head (Yaotou) is distinct from dizziness/vertigo. The text states: "If only the head and face shake, with sudden jaw stiffness (Koujin) and opisthotonos (back arching), this is Jing disease (Spasm Disease)." See the chapter on Spasm Disease for details. There is also shaking of the head indicating pain in the interior; this is not necessarily an adverse (fatal) sign. However, if Yang remains alone while Yin is exhausted, the body appears dark like smoke, with fixed staring and shaking of the head, this indicates the extinction of Heart Qi and is incurable.