时疫头痛与风寒不同∶风寒是寒束于上部，中、下无邪上逆，头虽甚痛而不昏闷；时疫是热蒸于上部，中焦邪
犯上焦，头不甚痛而皆闷，所谓卓然而痛者是也。验得气、色、神、脉、舌苔为时疫头痛，而又有表里之分。初
起头痛，脑后、巅顶、目珠略甚，舌苔白而发热者，太阳头痛也，羌活、川芎为主，豆豉、酒芩、知母、生地为
辅。额颅胀痛，目痛，鼻孔干，舌苔白而微黄，烦热而渴者，阳明头痛也，葛根为主，豆豉、石膏为辅。两额角
痛，眉棱骨痛，寒热往来，口苦咽干，舌苔中黄边白，或中段黄，尖上白，少阳头痛也，柴胡、荆芥、川芎为主，
酒芩、石膏为辅。头痛而三阳证悉具者，吴氏三消饮为
主。时疫头痛，专见一经证者少，杂见二、三经证者多，此方尤为多效，头痛甚者，加豆豉、芎、防清其头目。头
痛，舌苔黄，心下满，蒸蒸发热者，阳明里证也，三黄石膏汤、小承气汤、大柴胡汤、防风通圣散选用。舌苔黄，
或半截或旁边有一块白，胸满而呕，头痛兼眩者，痰厥头痛也，前胡为主，半夏、莱菔子、枳、桔、山楂、麦芽为
辅，兼烦热者，加大黄、枳实。汗、下、清解后，头痛心悸，四物汤去川芎，加丹皮、知母、黄柏，或归脾汤、逍
遥散并加生地、枣仁。凡头痛见证混杂，难分表里者，总以舌苔辨之。
时疫引起的头痛与风寒感冒不同：风寒是寒邪束缚于身体上部，中焦和下焦没有邪气上逆，所以头部虽然剧烈疼痛但不会感到昏沉闷胀；时疫则是热邪蒸腾于身体上部，中焦的邪气侵犯上焦，头部疼痛并不剧烈但都伴有闷胀感，这就是所谓“卓然而痛”（指疼痛位置固定且明显）的情况。通过观察患者的气色、神色、脉象和舌苔可以判断是否为时疫头痛，并且还要区分表证和里证。
初起时出现头痛，后脑勺、头顶、眼球部位疼痛略重，舌苔发白并伴有发热，这是太阳经头痛，以羌活、川芎为主药，豆豉、酒制黄芩、知母、生地黄为辅药。前额及颅骨胀痛，眼睛疼痛，鼻孔干燥，舌苔白而微黄，心烦发热且口渴，这是阳明经头痛，以葛根为主药，豆豉、石膏为辅药。两侧颞部（两额角）疼痛，眉棱骨疼痛，忽冷忽热，口苦咽干，舌苔中间黄边缘白，或者中段黄尖端白，这是少阳经头痛，以柴胡、荆芥、川芎为主药，酒制黄芩、石膏为辅药。头痛且具备三阳经症状者，以吴氏三消饮为主方。时疫头痛专门只表现出一经症状的很少，混杂表现出二经或三经症状的多，此方尤为有效；若头痛严重，加用豆豉、川芎、防风来清利头目。
头痛，舌苔黄，心下（胃脘部）痞满，像蒸汽一样持续发热，这是阳明经里证，选用三黄石膏汤、小承气汤、大柴胡汤、防风通圣散中的一种。舌苔黄，或者半截或旁边有一块白色区域，胸部胀满且呕吐，头痛兼有眩晕，这是痰厥头痛，以前胡为主药，半夏、莱菔子、枳壳、桔梗、山楂、麦芽为辅药，兼有心烦发热的，加大黄、枳实。经过发汗、攻下、清热解表治疗后，仍出现头痛心悸，用四物汤去掉川芎，加入牡丹皮、知母、黄柏，或者使用归脾汤、逍遥散并加入生地黄、酸枣仁。凡是头痛症状混杂，难以分辨表里的，总之以舌苔作为辨别依据。
Headache caused by epidemic pestilence differs from that of wind-cold: Wind-cold involves cold binding the upper part of the body, with no pathogenic factors in the middle or lower jiao reversing upward; thus, although the headache is severe, it is not accompanied by dizziness or stuffiness. Epidemic pestilence involves heat steaming the upper part, with pathogens from the middle jiao invading the upper jiao; the headache is not severe but is always accompanied by a sensation of stuffiness, which is referred to as "Zhuo Ran Er Tong" (distinct and fixed pain). By examining Qi, complexion, spirit, pulse, and tongue coating, one can identify epidemic headache and distinguish between exterior and interior syndromes.
In the initial stage, if headache is slightly more severe at the back of the head, vertex, and eyeballs, with a white tongue coating and fever, it is Taiyang headache. The main herbs are Qiang Huo (Notopterygii Rhizoma et Radix) and Chuan Xiong (Ligustici Chuanxiong Rhizoma), assisted by Dou Chi (Sojae Semen Praeparatum), Jiu Qin (Scutellariae Radix prepared with wine), Zhi Mu (Anemarrhenae Rhizoma), and Sheng Di Huang (Rehmanniae Radix). If there is distending pain in the forehead and skull, eye pain, dry nostrils, a white tongue coating turning slightly yellow, irritability, fever, and thirst, it is Yangming headache. The main herb is Ge Gen (Puerariae Lobatae Radix), assisted by Dou Chi and Shi Gao (Gypsum Fibrosum). If there is pain at both temples, pain in the supraorbital ridge, alternating chills and fever, bitter taste in the mouth, dry throat, and a tongue coating that is yellow in the center with white edges, or yellow in the middle section and white at the tip, it is Shaoyang headache. The main herbs are Chai Hu (Bupleuri Radix), Jing Jie (Schizonepetae Herba), and Chuan Xiong, assisted by Jiu Qin and Shi Gao. For headache where symptoms of all three Yang meridians are present, Wu's San Xiao Yin (Three-Draining Decoction) is the main formula. In epidemic headaches, cases showing symptoms of only one meridian are rare, while those mixing symptoms of two or three meridians are common; this formula is particularly effective. For severe headache, add Dou Chi, Xiong (Chuan Xiong), and Fang Feng (Saposhnikoviae Radix) to clear the head and eyes.
If there is headache, a yellow tongue coating, fullness below the heart (epigastric region), and steaming fever, it is a Yangming interior syndrome. Selectively use San Huang Shi Gao Tang (Three-Yellow Gypsum Decoction), Xiao Cheng Qi Tang (Minor Order the Qi Decoction), Da Chai Hu Tang (Major Bupleurum Decoction), or Fang Feng Tong Sheng San (Saposhnikovia Releasing the Exterior Powder). If the tongue coating is yellow, or has a patch of white on half or the side, with chest fullness, vomiting, headache, and dizziness, it is Phlegm-Jue headache. The main herb is Qian Hu (Peucedani Radix), assisted by Ban Xia (Pinelliae Rhizoma), Lai Fu Zi (Raphani Fructus), Zhi (Zhi Ke - Aurantii Fructus), Jie Geng (Platycodonis Radix), Shan Zha (Crataegi Fructus), and Mai Ya (Hordei Fructus Germinatus). If accompanied by irritability and fever, add Da Huang (Rhei Radix et Rhizoma) and Zhi Shi (Aurantii Fructus Immaturus). After sweating, purging, or clearing and resolving treatments, if headache and palpitations persist, use Si Wu Tang (Four Substances Decoction) removing Chuan Xiong, adding Dan Pi (Moutan Cortex), Zhi Mu, and Huang Bo (Phellodendri Cortex); or use Gui Pi Tang (Restore the Spleen Decoction) or Xiao Yao San (Free Wanderer Powder) added with Sheng Di Huang and Zao Ren (Ziziphi Spinosae Semen). Whenever headache symptoms are mixed and difficult to distinguish between exterior and interior, rely primarily on the tongue coating for differentiation.