卫气者所以温分肉充皮肤肥腠理司开阖者也故风邪中于卫也则必恶风恶风恶寒俱为表证但恶风比恶寒为轻耳恶寒
者虽不当风而时自怯寒恶风者居密室之中帏幕之内则无所畏或当风或挥扇则淅淅然而恶也恶寒则有阴阳之分恶风惟属
阳耳所以三阴之证并无恶风恶风虽在表而发散又自不同若无汗恶风则为伤寒当发其汗故用麻黄汤若汗出恶风则为中风
当解其肌故用桂枝汤里证虽具而恶风未罢皆当先解其外也发热恶风为表虚属太阳病(见发热太阳病条)发汗后遂汗漏不
止其证似风湿相搏证背恶风汗出小便不利四肢难以屈伸但心下不满者身不痛用桂枝加附子汤(见自汗)风湿相搏者骨节
烦疼掣痛用甘草附子汤(方见体痛)身热恶风项强胁满手足温而渴者用小柴胡汤(见胁痛)
伤寒头痛虽属三阳惟太阳经独多盖太阳为病属表而头痛专为主表虽有伤寒六七日头痛不大便有热而与承气汤下之
者却云若小便清者知热不在里仍在表是知头痛属表明矣太阴少阴二经之脉从足至胸而还不上循头故无头痛惟厥阴脉循
喉咙之后上连目系与督脉会于巅亦有头痛干呕吐涎沫吴茱萸汤一证却无身热亦与阳证不同也然风温病在少阴湿温病在
太阴而头反痛至于阴毒亦然是又不可拘拘为者内因头痛作止有时外因头痛常常有之直须传入里方罢
发热头痛恶风属太阳(方论见太阳病发热)大便(汗) 不利六七日头痛身热小便赤者宜承气汤若小便利者知不在
里仍在表须发汗若头痛者必衄宜桂枝汤(论见胃实)服(和解) 桂枝汤或下之仍头项强痛翕翕发热兼心下满微痛小便
不利者桂枝去桂加茯苓白术汤(方论见项强)太阳(下)中风下利呕逆表解者可攻之其人 汗出发作有时头痛心下痞
硬引胁下痛干呕短气汗出不恶寒者表解里未和也十枣汤(方论见胁满痛)
张 或谓十枣汤与桂枝去桂加茯苓白术汤二者皆属饮家俱有头项强痛之病何也此经络所系非偶尔而言也针经曰太
阳膀胱之脉起于目内 皆上额交巅上其支者从巅上至耳上角直者从巅入络脑还出至下项循肩膊内侠脊抵腰中入循膂络
肾属膀胱上文所络肾者即三焦也夫三焦者为阳气之父决渎之官引导阴阳开通闭塞水道出以化气而言也缘太阳经多血少
气既病则气愈弱其时表病而里热未甚微渴而恣饮水浆为水多气弱不能施化遂停伏于内则本经血气因而凝滞致有头痛项
强之患矣若伏饮流行经络疏利而头痛自愈矣
病(温)发热头痛脉反沉若不瘥身痛当救里四逆汤(论见发热)太阳病(刺)头痛至七日以上自愈者以行其经尽故
也若欲作再经者针足阳明使经不传则愈(伤寒自一日至六日传三阳三阴经尽至七日当愈经曰七日太阳病衰头痛少愈若七
日不愈则太阳之邪再传阳明针足阳明为迎而夺之使经不传则愈(吴)脉浮头痛太阳也须刺腕骨京骨又云表证头疼恶寒发
热刺合谷)
阳明(和解)身热头痛漱水不欲咽必发衄脉数者犀角地黄汤茅花汤(见鼻衄)阳明病表里大热烦渴引饮头痛如破者
宜竹叶石膏汤 阳明头痛不恶寒反恶热大便实调胃承气汤 阳明病反无汗而小便利二三日呕而咳手足厥者必苦头痛若
不咳不呕手足不厥者头不痛(内经曰巨阳受邪少阴为里得热则上从之厥也太阳与少阴为合此证当是太阳未全罢耳经又曰
阳明则喘而 则恶人小便利者寒邪内攻肢厥头痛者寒邪外攻也)
吴 阳明头痛额前目疼鼻干脉长也无汗者葛根加葱白白芷汗之若有汗曾经发汗头痛不解者宜葛根葱白汤主之若不
恶风而反恶热自汗烦渴脉洪数饮水头疼者白虎加白芷汤主之若内有燥屎蒸蒸发热头痛者调胃承气汤主之凡阳明头痛无
汗者葛根麻黄葱白白芷石膏之属也有汗则白芷石膏葛根川芎汤也
伤寒(和解)脉弦细头痛发热者属少阳不可发汗汗之则谵语此属胃胃和则愈胃不和则烦而悸宜小柴胡汤(论见口苦)
吴 少阳经头痛头角或耳中痛脉弦数口苦发热往来寒热者并用小柴胡汤和之一方加川芎尤妙盖川芎亦胆经药也凡
少阳头痛不分有汗无汗皆以柴胡汤主之不时头痛及发寒热脉紧不大即是上膈有痰瓜蒂散吐之
头痛干呕吐涎沫者吴茱萸汤(方论见吐)活人云厥阴头痛为欲愈小建中汤
活 若已发汗或未发汗头痛如破者用连须葱白汤
连须葱白汤方
葱白(连须切半升) 生姜(二两)上以水二升煮取一升分二次温服再不止者宜服后方
葛根葱白汤方
葛根 芍药 知母(各半两) 川芎 葱白 生姜(各一两)上以水三升煎至一升热服 若不时头疼胸中满及发寒
热脉紧而不大者即是膈上有涎宜用瓜蒂末一钱暖水调下吐涎立愈
云 伤寒汗下后头痛起目眩者宜独活汤
防风 独活 旋复花 当归(各七钱)上 咀姜水同煎服
伤寒热病后头痛不止者用石膏川芎汤
石膏 川芎(各一两)上 咀每服五钱水煎服
海 太阳头痛有汗桂枝汤无汗麻黄汤 阳明头痛白虎汤 少阳头痛小柴胡汤 太阴头痛脉浮桂枝汤脉沉理中汤俱
加川芎细辛 少阴头痛小柴胡汤麻黄附子细辛汤 厥阴头痛外伤本经桂枝麻黄各半汤 呕而微吐苦水者吴茱萸汤
垣 太阴头痛者必有痰也少阴头痛者足寒而气逆也盖太阴少阴二经虽不至头然痰与气逆壅于膈中则头上气不得畅
降而为痛也
云 如脉浮而头痛过在手足太阳刺完骨京骨 如脉浮而长过在手足阳明刺合谷冲阳 如脉浮而弦过在手足少阳刺阳池邱墟风府风池此刺头痛之法也
集 伤寒头痛刺谷攒竹
卫气,是用于温煦肌肉、充实皮肤、肥厚腠理并主管汗孔开阖的气。因此,风邪侵袭卫分时,必然会出现恶风的症状。恶风和恶寒都属于表证,但恶风比恶寒的程度要轻。所谓恶寒,是指即使不在风口,也时常感到怕冷;所谓恶风,是指在密室帷帐之中尚且无所畏惧,但若当风或挥扇,则会有瑟瑟发抖的畏风感。恶寒有阴证和阳证之分,而恶风则只属于阳证。所以,三阴病证中并没有恶风这一症状。
虽然恶风也在表证范畴,但其发散治疗又有所不同:若无汗且恶风,则为伤寒,应当发汗,故使用麻黄汤;若汗出且恶风,则为中风,应当解肌,故使用桂枝汤。即使里证已经具备,只要恶风未罢,都应当先解除表邪。发热伴恶风属于表虚,归属于太阳病(参见“发热·太阳病”条)。发汗后导致汗漏不止,其证候类似风湿相搏证,表现为背部恶风、汗出、小便不利、四肢难以屈伸,但如果心下没有痞满感,身体也不痛,应使用桂枝加附子汤(参见“自汗”条)。若是风湿相搏证,则见骨节烦疼、掣痛,应使用甘草附子汤(方剂见“体痛”条)。身热、恶风、项强、胁满、手足温且口渴者,应使用小柴胡汤(参见“胁痛”条)。
伤寒引起的头痛虽属三阳经病,但唯独太阳经最为多见。因为太阳病属于表证,而头痛专门作为主表证的指征。虽然有伤寒六七日出现头痛不大便且有热的情况,给予承气汤攻下时,却说“如果小便清亮,说明热不在里,仍在表”,由此可知头痛属于表证是很明确的。太阴经和少阴经的脉气从足上行至胸而还,不向上循行到头部,所以这两经的病没有头痛。只有厥阴经的脉气循喉咙之后,上连目系,与督脉会于巅顶,所以也有头痛。干呕吐涎沫的吴茱萸汤证,却没有身热,这与阳证不同。然而,风温病在少阴,湿温病在太阴,反而出现头痛,这种情况又不可以拘泥于上述说法。内因引起的头痛发作有时,外因引起的头痛常常存在,直到病邪传入里部才会停止。
发热、头痛、恶风属于太阳病(方论见“太阳病发热”)。大便不利,六七日头痛、身热、小便赤者,宜用承气汤;若小便利者,知病不在里,仍在表,须发汗;若头痛者,必致鼻衄,宜用桂枝汤(论见“胃实”)。服用桂枝汤或经过攻下后,仍然头项强痛、翕翕发热、兼有心下满微痛、小便不利者,宜用桂枝去桂加茯苓白术汤(方论见“项强”)。太阳中风下利、呕逆,表解者可攻之。其人汗出发作有时、头痛、心下痞硬、引胁下痛、干呕、短气、汗出而不恶寒者,为表解里未和,宜用十枣汤(方论见“胁满痛”)。
有人问:十枣汤与桂枝去桂加茯苓白术汤,二者皆属于饮家(水饮病患者),都有头项强痛的病证,为什么呢?这是经络所系的缘故,并非偶然而言。《针经》说:太阳膀胱之脉起于目内眦,皆上额交巅上;其支者,从巅上至耳上角;直者,从巅入络脑,还出至下项,循肩膊内,侠脊抵腰中,入循膂,络肾,属膀胱。上文所说的“络肾”,即指三焦。夫三焦者,为阳气之父,决渎之官,引导阴阳,开通闭塞,水道出以化气。缘于太阳经多血少气,既病则气愈弱,此时表病而里热未甚,微渴而恣意饮水浆,因水多气弱不能施化,遂停伏于内,则本经血气因而凝滞,致使有头痛项强之患。若伏饮流行,经络疏利,而头痛自愈矣。
病温发热头痛,脉反沉,若不愈,身痛当救里,用四逆汤(论见“发热”)。太阳病头痛,至七日以上自愈者,是因为行其经尽的缘故。如果想要发生传经,针刺足阳明经,使经气不传则愈。(伤寒自一日至六日,传遍三阳三阴经尽,至七日当愈。经曰:七日太阳病衰,头痛少愈。若七日不愈,则太阳之邪再传阳明,针刺足阳明为迎而夺之,使经不传则愈。)脉浮头痛,属太阳,须刺腕骨、京骨。又说:表证头疼恶寒发热,刺合谷。
阳明病身热、头痛、漱水不欲咽,必发衄,脉数者,用犀角地黄汤、茅花汤(见“鼻衄”)。阳明病表里大热、烦渴引饮、头痛如破者,宜竹叶石膏汤。阳明头痛,不恶寒反恶热,大便实,用调胃承气汤。阳明病反无汗而小便利,二三日呕而咳,手足厥者,必苦头痛;若不咳不呕,手足不厥者,头不痛。(《内经》曰:巨阳受邪,少阴为里,得热则上从之厥也。太阳与少阴为合,此证当是太阳未全罢耳。经又曰:阳明则喘而恶人。小便利者,寒邪内攻;肢厥头痛者,寒邪外攻也。)
吴氏认为:阳明头痛,额前目疼鼻干,脉长,无汗者,用葛根加葱白、白芷发汗;若有汗,曾经发汗头痛不解者,宜葛根葱白汤主之;若不恶风而反恶热,自汗烦渴,脉洪数,饮水头疼者,白虎加白芷汤主之;若内有燥屎,蒸蒸发热,头痛者,调胃承气汤主之。凡阳明头痛无汗者,用葛根、麻黄、葱白、白芷、石膏之类;有汗则用白芷、石膏、葛根、川芎汤。
伤寒脉弦细、头痛发热者,属少阳,不可发汗,汗之则谵语。此属胃,胃和则愈,胃不和则烦而悸,宜小柴胡汤(论见“口苦”)。吴氏认为:少阳经头痛,头角或耳中痛,脉弦数,口苦,发热往来寒热者,并用小柴胡汤和解;一方加川芎尤妙,盖川芎亦胆经药也。凡少阳头痛,不分有汗无汗,皆以柴胡汤主之。不时头痛及发寒热,脉紧不大,即是上膈有痰,用瓜蒂散吐之。
头痛、干呕吐涎沫者,用吴茱萸汤(方论见“吐”)。《活人书》云:厥阴头痛为欲愈,用小建中汤。若已发汗或未发汗,头痛如破者,用连须葱白汤。
连须葱白汤方:葱白(连须切半升)、生姜(二两)。上以水二升,煮取一升,分二次温服。再不止者,宜服后方。
葛根葱白汤方:葛根、芍药、知母(各半两)、川芎、葱白、生姜(各一两)。上以水三升,煎至一升,热服。若不时头疼,胸中满及发寒热,脉紧而不大者,即是膈上有涎,宜用瓜蒂末一钱,暖水调下,吐涎立愈。
云岐子云:伤寒汗下后头痛起目眩者,宜独活汤。防风、独活、旋复花、当归(各七钱)。上咀,姜水同煎服。
伤寒热病后头痛不止者,用石膏川芎汤。石膏、川芎(各一两)。上咀,每服五钱,水煎服。
海藏先生云:太阳头痛,有汗用桂枝汤,无汗用麻黄汤;阳明头痛用白虎汤;少阳头痛用小柴胡汤;太阴头痛,脉浮用桂枝汤,脉沉用理中汤,俱加川芎、细辛;少阴头痛用小柴胡汤、麻黄附子细辛汤;厥阴头痛外伤本经,用桂枝麻黄各半汤;呕而微吐苦水者,用吴茱萸汤。
李东垣云:太阴头痛者必有痰也;少阴头痛者足寒而气逆也。盖太阴、少阴二经虽不至头,然痰与气逆壅于膈中,则头上气不得畅降而为痛也。
云岐子云:如脉浮而头痛,过在手足太阳,刺完骨、京骨;如脉浮而长,过在手足阳明,刺合谷、冲阳;如脉浮而弦,过在手足少阳,刺阳池、邱墟、风府、风池。此刺头痛之法也。
Wei Qi (Defensive Qi) is that which warms the flesh, fills the skin, thickens the interstices (Cou Li), and governs the opening and closing of the pores. Therefore, when Wind Evil invades the Wei level, it inevitably causes aversion to wind. Aversion to wind and aversion to cold are both exterior syndromes, but aversion to wind is milder than aversion to cold. "Aversion to cold" refers to feeling chilly spontaneously even when not exposed to wind; "aversion to wind" refers to feeling no fear within a sealed room or behind curtains, but shivering with fear when exposed to wind or fanning oneself. Aversion to cold has distinctions between Yin and Yang syndromes, whereas aversion to wind belongs exclusively to Yang syndromes. Thus, there is no aversion to wind in the Three Yin diseases.
Although aversion to wind occurs in exterior syndromes, its treatment for dispersing differs: if there is no sweating and aversion to wind, it is Cold Damage (Shang Han), requiring diaphoresis, so Ma Huang Tang (Ephedra Decoction) is used; if there is sweating and aversion to wind, it is Wind Strike (Zhong Feng), requiring muscle-relieving resolution, so Gui Zhi Tang (Cinnamon Twig Decoction) is used. Even if interior syndromes are present, as long as aversion to wind has not ceased, the exterior must be resolved first. Fever with aversion to wind indicates exterior deficiency and belongs to Taiyang Disease (see "Fever · Taiyang Disease" section). After sweating, if leakage of sweat continues unceasingly, the syndrome resembles Bi Syndrome due to Wind-Dampness, presenting with back aversion to wind, sweating, difficulty in urination, and stiffness in the four limbs making flexion and extension difficult; however, if there is no fullness below the heart and no body pain, Gui Zhi Jia Fu Zi Tang (Cinnamon Twig Decoction plus Aconite) should be used (see "Spontaneous Sweating"). If it is Bi Syndrome due to Wind-Dampness, there will be painful and pulling pain in the bone joints, treated with Gan Cao Fu Zi Tang (Licorice and Aconite Decoction) (formula see "Body Pain"). For body heat, aversion to wind, neck stiffness, hypochondriac fullness, warm hands and feet, and thirst, Xiao Chai Hu Tang (Minor Bupleurum Decoction) is used (see "Hypochondriac Pain").
Headache caused by Cold Damage, although belonging to the Three Yang meridians, is most common in the Taiyang meridian. This is because Taiyang disease belongs to the exterior, and headache serves specifically as a sign of an exterior syndrome. Although there are cases of Cold Damage lasting six or seven days with headache, constipation, and heat, where Cheng Qi Tang (Order the Qi Decoction) is administered to purge, it is stated that "if the urine is clear, one knows the heat is not in the interior but remains in the exterior." From this, it is known that headache belongs to the exterior clearly. The meridians of the Taiyin and Shaoyin ascend from the foot to the chest and return without going up to the head; therefore, diseases of these two meridians do not involve headache. Only the Jueyin meridian follows the throat posteriorly, connects to the eye system, and meets the Du Meridian at the vertex, thus also involving headache. The Wu Zhu Yu Tang (Evodia Decoction) syndrome characterized by dry vomiting and spitting of saliva lacks fever, differing from Yang syndromes. However, in Wind-Warmth disease located in Shaoyin and Damp-Warmth disease located in Taiyin, headache appears conversely; such cases cannot be rigidly bound by the aforementioned rules. Headaches caused by internal factors occur intermittently, while those caused by external factors are constant until the pathogen transmits to the interior.
Fever, headache, and aversion to wind belong to Taiyang (formula theory see "Taiyang Fever"). If bowel movements are difficult, and after six or seven days there is headache, body heat, and red urine, Cheng Qi Tang is suitable; if urination is free, the disease is not in the interior but remains in the exterior, requiring diaphoresis; if there is headache, epistaxis will likely occur, and Gui Zhi Tang is suitable (theory see "Stomach Excess"). After taking Gui Zhi Tang or undergoing purgation, if head and neck stiffness, mild fever, slight fullness and pain below the heart, and difficulty in urination persist, Gui Zhi Qu Gui Jia Fu Ling Bai Zhu Tang (Cinnamon Twig Decoction minus Cinnamon plus Poria and Atractylodes Macrocephala Decoction) is used (formula theory see "Neck Stiffness"). In Taiyang Wind Strike with diarrhea and vomiting/retching, once the exterior is resolved, attack can proceed. If the patient has intermittent sweating, headache, hard fullness below the heart radiating to the hypochondrium, dry vomiting, shortness of breath, sweating without aversion to cold, this indicates the exterior is resolved but the interior is not harmonized; Shi Zao Tang (Ten Jujubes Decoction) is used (formula theory see "Hypochondriac Fullness and Pain").
It is asked: Both Shi Zao Tang and Gui Zhi Qu Gui Jia Fu Ling Bai Zhu Tang belong to patients with fluid retention (Yin Jia) and both present with head and neck stiffness. Why? This is due to meridian connections, not coincidence. The *Needle Classic* states: The Taiyang Bladder meridian originates from the inner canthus, goes up to the forehead and crosses the vertex; its branch goes from the vertex to the supra-auricular angle; the straight branch enters the brain from the vertex, emerges at the lower nape, runs along the shoulder blades, parallel to the spine to the middle of the waist, enters the muscles, connects to the Kidney, and belongs to the Bladder. The "connecting to the Kidney" mentioned above refers to the San Jiao (Triple Burner). The San Jiao is the father of Yang Qi, the official of drainage, guiding Yin and Yang, opening blockages, allowing water pathways to emerge and transform Qi. Since the Taiyang meridian has abundant blood but scarce Qi, upon disease, Qi becomes weaker. At this time, with exterior pathology and mild interior heat causing slight thirst, excessive drinking of fluids occurs. Due to weak Qi failing to transform the excess fluid, it stagnates internally, causing stagnation of blood and Qi in the primary meridian, resulting in headache and neck stiffness. If the retained fluid circulates and the meridians are unblocked, the headache heals itself.
In Warmth disease, if there is fever, headache, and a sinking pulse, and if it does not improve with body pain, the interior should be rescued using Si Ni Tang (Frigid Extremities Decoction) (theory see "Fever"). In Taiyang disease, headache may heal spontaneously after seven days because the meridian cycle is completed. If transmission to another meridian is anticipated, needling the Foot-Yangming meridian prevents transmission and leads to recovery. (Cold Damage transmits through the Three Yang and Three Yin meridians over six days; by the seventh day, it should heal. The Classic says: On the seventh day, Taiyang disease declines, and headache lessens. If it does not heal by the seventh day, Taiyang evil transmits to Yangming. Needling Foot-Yangming uses the "meet and drain" method to prevent transmission.) For floating pulse and headache belonging to Taiyang, Wan Gu (SI4) and Jing Gu (BL64) should be needled. It is also said: For exterior syndrome headache with aversion to cold and fever, He Gu (LI4) should be needled.
For Yangming disease with body heat, headache, rinsing the mouth without desire to swallow, leading to epistaxis, and rapid pulse, Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) and Mao Hua Tang (Mao Hua Decoction) are used (see "Epistaxis"). For Yangming disease with severe interior and exterior heat, irritability, thirst with desire to drink, and headache like bursting, Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) is suitable. For Yangming headache without aversion to cold but with aversion to heat and solid stool, Tiao Wei Cheng Qi Tang (Regulate the Weight Order the Qi Decoction) is used. For Yangming disease with paradoxical absence of sweating but free urination, vomiting and coughing after two or three days, and cold extremities, severe headache must occur; if there is no vomiting/coughing and extremities are not cold, there is no headache. (*Inner Classic*: Juyang receives evil, Shaoyin is interior; getting heat causes upward reversal. Taiyang and Shaoyin are paired; this case implies Taiyang has not fully resolved. Another classic says: Yangming involves panting and aversion to people. Free urination indicates cold evil attacking internally; cold extremities and headache indicate cold evil attacking externally.)
Wu states: For Yangming headache with frontal eye pain and nasal dryness, long pulse, and no sweating, Ge Gen plus Cong Bai (Scallion White) and Bai Zhi (Angelica Dahurica) induces sweating; if sweating exists and previous sweating failed to resolve headache, Ge Gen Cong Bai Tang is used; if there is no aversion to wind but aversion to heat, spontaneous sweating, irritability, thirst, rapid and large pulse, and headache with drinking, Bai Hu Jia Bai Zhi Tang (White Tiger plus Angelica Dahurica Decoction) is used; if there are dry feces internally, steaming fever, and headache, Tiao Wei Cheng Qi Tang is used. Generally, for Yangming headache without sweating, use Ge Gen, Ma Huang, Cong Bai, Bai Zhi, Shi Gao; with sweating, use Bai Zhi, Shi Gao, Ge Gen, Chuan Xiong Tang.
For Cold Damage with wiry-thin pulse, headache, and fever, it belongs to Shaoyang; diaphoresis is contraindicated as it causes delirium. This relates to the Stomach; if the Stomach harmonizes, it heals; if not, irritability and palpitations occur. Xiao Chai Hu Tang is suitable (theory see "Bitter Taste"). Wu states: For Shaoyang meridian headache with pain at the temple or ear, wiry-rapid pulse, bitter taste, fever, and alternating chills and fever, Xiao Chai Hu Tang is used for harmonization; adding Chuan Xiong is excellent as it is a Gallbladder meridian herb. Generally, for Shaoyang headache regardless of sweating, Chai Hu Tang is used. For intermittent headache with chills/fever and tight, small pulse, phlegm in the upper diaphragm is indicated, treated with Gua Di San (Melon Seed Powder) to induce vomiting.
For headache with dry vomiting and spitting saliva, Wu Zhu Yu Tang is used. *Li Ren Shu* states: Jueyin headache indicates impending recovery, treated with Xiao Jian Zhong Tang. If sweating has occurred or not, and headache is severe, Lian Xu Cong Bai Tang (Scallion White with Roots Decoction) is used.
Lian Xu Cong Bai Tang Formula: Scallion White (with roots, cut, half sheng), Ginger (two liang). Boil in two sheng of water to obtain one sheng, divide into two doses, take warm. If ineffective, use the following formula.
Ge Gen Cong Bai Tang Formula: Ge Gen, Shao Yao, Zhi Mu (each half liang), Chuan Xiong, Cong Bai, Sheng Jiang (each one liang). Boil in three sheng of water to obtain one sheng, take hot. For intermittent headache, chest fullness, chills/fever, and tight/small pulse indicating phlegm in the diaphragm, use one qian of Gua Di Mo mixed with warm water to induce vomiting of phlegm for immediate relief.
Yun Qi Zi states: For headache and vertigo after sweating and purgation in Cold Damage, Du Huo Tang is suitable. Fang Feng, Du Huo, Xuan Fu Hua, Dang Gui (each seven qian). Chew, decoct with ginger water.
For persistent headache after febrile Cold Damage, Shi Gao Chuan Xiong Tang is used. Shi Gao, Chuan Xiong (each one liang). Chew, take five qian per dose, decoct in water.
Hai Zang states: Taiyang headache with sweating uses Gui Zhi Tang; without sweating, Ma Huang Tang. Yangming headache uses Bai Hu Tang. Shaoyang headache uses Xiao Chai Hu Tang. Taiyin headache: floating pulse uses Gui Zhi Tang; sinking pulse uses Li Zhong Tang, both added with Chuan Xiong and Xi Xin. Shaoyin headache uses Xiao Chai Hu Tang and Ma Huang Fu Zi Xi Xin Tang. Jueyin headache due to external injury to the primary meridian uses Gui Zhi Ma Huang Ge Ban Tang. Vomiting with slight bitter water expulsion uses Wu Zhu Yu Tang.
Li Dong Yuan states: Taiyin headache necessarily involves phlegm; Shaoyin headache involves cold feet and rebellious Qi. Although Taiyin and Shaoyin meridians do not reach the head, phlegm and rebellious Qi obstructing the diaphragm prevent Qi from descending smoothly to the head, causing pain.
Yun Qi Zi states: For floating pulse and headache affecting Hand-Foot Taiyang, needle Wan Gu and Jing Gu. For floating-long pulse affecting Hand-Foot Yangming, needle He Gu and Chong Yang. For floating-wiry pulse affecting Hand-Foot Shaoyang, needle Yang Chi, Qiu Xu, Feng Fu, Feng Chi. These are methods for needling headache.
*Ji Yan Fang* states: For Cold Damage headache, needle Zan Zhu.