头痛是病证，头风是病名，本不须辨。或谓为有新久去留之分者，凿矣。
脉候 脉紧上寸口者中风，风头痛亦如之（《千金翼》
云亦为伤寒头痛）。脉弦上寸口者宿食，降者头痛。病若头痛、目痛，脉反短涩者死。（《脉经》）
头痛短涩应须死，浮滑风痰皆易除。（《脉诀》）
头痛阳弦，浮风紧寒，风热洪数，湿细而坚。气虚头痛，虽弦必涩，痰厥则滑，肾厥坚实。（《崔氏脉诀》）
痰厥之脉，时伏时见。（《大成》）
脑痛，脉缓大者死。（《丹溪》）
源由证治总说 头面风者，是体虚，诸阳经脉为风所乘
也。诸阳经脉上走于头面，运动劳役，阳气发泄，腠理开而
受风，谓之首风。（此下原举经文，不录。）又新沐头未干，不可以卧，使头重身热。反得风则烦闷。诊其
脉，寸口阴阳表里互相乘。如风在首，久不瘥，则风入脑，变为头眩。（《病源论》）
夫风头痛者，凡人体虚，外伤风邪，流入阳经，行于六腑，或腠理开张，风毒攻注于风府，故心膈烦热，
头面虚汗，上 壅滞，故令头重疼痛也。（《圣惠》）
头者诸阳之会，凡头痛者，乃足太阳受病。上连风府眉角而痛者，皆可药愈。或上穿风府，隐入于泥丸宫
而痛者，是为真头疼，不可以药愈，夕发旦死，旦发夕死，责在根气先绝也。原其所因，有中风寒暑湿而疼
者，有气血食饮厥而疼者，有五脏气郁厥而疼者。治之之法，当先审其三因，三
因既明，则无施不切中。（《三因》）
头痛非一种，有风冷头疼，痰厥头疼，肾厥头疼，积滞头疼，气虚头疼，偏正头疼，嗅毒头疼，伤寒头
疼，膈痰风厥头痛，更有夹脑风、洗头风，治之各有方。（《续易简》）
夫人头者，诸阳之所聚。诸阴脉皆至颈而还，独诸阳脉皆上至头耳，则知头面皆属阳部也。且平居之人，
阳顺于上而不逆，则无头痛之患。阳逆于上而不顺，冲壅于头，故头痛也。风寒在脑，邪热上攻，痰厥肾厥，
气虚气攻，皆致头痛。但气虚气攻头痛，愈而复作，延引岁月者，多有之矣。偏正头风，妇人气盛血虚，产
后失血过多，气无所主，皆令头痛。（《济生续》）
足太阳者，头之经也。六经伤寒，惟太阳受病最多。盖头居其上，当风寒之冲，一有间隙，则若顶若脑，
若耳若鼻，风邪乘虚，皆得而入之矣，况复栉沐取凉、饱食仰卧之不
谨乎。头风为病，不必须有偏正头疼之证，但自颈项以上，
耳目口鼻眉棱之间，或有一处不若吾之体焉，皆其渐也。有头疼，有头运，有头皮顽浓（按∶《入门》改浮顽
），不自觉知，有口舌不仁，莫知滋味，或耳聋，或头汗，或目痛，或眉棱上下掣痛，或鼻中闻香极香，闻臭
极臭，或只呵欠而作冒眩之状，凡此皆头风证也。治法大要，有热证者消风散，用防风、荆芥煎汤下。无热
证者追风散（系川乌、石膏等大方。难于适用），用薄茶清下。又有素患头风之人，或因伤风寒暑湿，
根据证调理已获轻安，未几头风发作，则不必拘泥前药，当以头风和平之剂疗之。其或病躯老弱，先患头风，复
感寒邪，自汗不止，此等用药，无附子又不可也。（妇人月候适行，辄敢梳篦，多成头风痒痛，满头如水泡
之状。）（《直指》）
夫头痛不止，乃三阳之受病也，三阳者各分部分。头与项痛者，是足太阳膀胱之经也。攒竹痛，俗呼
为眉棱痛者，是阳明经也。额角上痛，俗呼为偏头痛者，是少阳经也。如痛久不已，则令人丧目。以三阳
受病，皆胸膈有宿痰之致然也，先以茶调散吐之，后以香薷散、白虎汤投之则愈。然头痛不止，可煎葱白须、
豆豉汤吐之，吐讫可服川芎、薄荷，辛凉清上，搜风丸、香芎散（并见《三法六门》）之类。（《治病百法》）
内因头痛，时作时止，外因头痛，常常有之。（《永类》）
诸头痛有六证∶伤风，头痛或半边偏痛，皆因冷风所吹，遇风冷则发，脉寸浮者是也。食积，因胃中有
阴冷宿食不化，上冲头痛，右手脉浮紧甚者是也。（按∶《六要》曰∶右关寸脉滑而实，证兼呕吐恶心，心下
痞闷或痛，或寒热如疟，乃食郁头痛也，治须消导。）气虚，因下部气虚上攻，温温
而痛，异乎邪毒所攻，脉尺虚浮是也。伤寒，在太阳经，其
痛如破，关前脉数是也，紧数是也。阳明经胃热上攻，右关洪大而数是也。（按∶《金匮翼》曰∶热厥
头痛者，胃热气盛，不能下行也。其证头中热痛，虽严冬犹喜风寒，微来暖处或见烟火，则痛复作，其脉数
或大者是也。）膈上有风涎冷痰而或呕吐，脉弦细出于寸口是也。（《丹溪》）
血虚头痛，自鱼尾上攻头痛，用芎归汤，古方有追涎药。（同上）
头为清阳之分，外而六淫之邪气相侵，内而脏腑经脉之邪气上逆，皆能乱其清气，相搏击致痛，须分内
外虚实。实者，其人血气本不虚，为外邪所犯，或蔽复其清明，或壅塞其经络，或内之实火上炎，因而血瘀涎
滞，不得通行而痛，其痛必甚，此为实。虚者，其人气血本虚，为外邪所犯，或内之浊阴上干，虽亦血瘀涎滞
不能通行，而搏击无力，其痛不甚，此为虚。（《准绳》谓真气虚寒，遇外之寒湿所侵，血涩脉寒，卷缩
紧急，引其小络而痛，得暖则痛止。）（按∶此全文亦本于《准绳》而加删订者。所引之文则系取之《举
痛论》。）实者，邪气实而正气不虚，可任攻。虚者，正气自虚而邪气自实，补正仍须治邪。若邪
亦不实，但补正则邪自退。（《医碥》）
因风而痛者，抽掣恶风，有汗而痛。因暑热而痛者，或有汗，或无汗，则皆恶热而痛。因湿而痛者，痛而
头重，遇天阴尤甚。因痰饮而痛者，亦头昏重而痛，愦愦欲吐。因寒而痛者，恶寒而脉绌急。气虚而痛者，
遇劳则痛甚，其脉大。血虚而痛者，善惊惕，其脉芤。（《金匮翼》）（按∶此系《准绳》节文。《翼》
更分头痛为十一类∶曰风，曰热厥，曰湿热，曰寒湿，曰痰厥，曰肾虚，曰肝厥，曰食积，曰血虚，曰气虚，曰偏。）
血虚头痛，必有烦躁、发渴、身热等候，其脉必涩而虚，产后金疮失血者多有之，虽宜补血，又必兼养
其气，以血非气不生也。若阴虚水亏，火动而痛者，宜沉阴至静之品，补水以制其火，尤不宜过用芎、归，助
其升散也。气虚头痛，必有倦怠少食、或畏寒、或羞明等候，其脉必微而细，或大而空，亦久病年高者有之，
必于补气之中，兼用姜、桂以扶其阳，少佐芎、辛以达其气也。痰厥头痛，必有呕恶、胸满、咳嗽、气逆、多
痰等证。其脉必弦而滑。又有火邪头痛者，虽诸经皆能为害，而惟阳明为最，以阳明胃火盛于头面，而直达头
维，故其痛必甚，其脉必洪，其证必口渴躁热，宜知母、花粉、生地、麦冬、甘草之类，以抑阳而生阴，甚
则白虎汤，以迎秋气而却炎威，其效最速。（《汇论》）
头痛∶挟风寒者，忌补敛，宜辛温发散。挟邪热者，忌同挟风寒者，宜辛寒、苦寒、解散。挟痰者，
忌升、补敛、酸甘、滞腻，宜豁痰降气、辛燥。阴虚者，忌辛热发散，宜补血益阴、
甘寒、酸寒。（《本草经疏》）
病因肾虚（肝虚眩晕肾虚证治） 《素问》云∶头痛巅疾，下虚上实，过在足少阴巨阳，甚则入肾。
徇蒙招摇，目瞑耳聋，下实上虚，过在足少阳厥阴，甚则入肝。下虚者肾虚也，故肾虚则头痛。（按∶原以
玉真丸为主，今举降逆方中。）上虚者肝虚也，故肝虚则头晕。徇蒙者，如以物蒙其首。招摇不定，目眩
耳聋，皆晕之状也。故肝厥头晕、肾厥巅痛不同如此。（《本事》）
肾虚，耳鸣面黑小便多，真黑锡丹，煎苏子降气汤下，沉附汤、术附汤加芎、辛。（《永类》）
因虚头痛，此为肾厥头痛，宜用正元散（见《和剂》系乌、
附等大方），或大三五七散入盐煎服，或于正元散内入炒椒
十五粒下来复丹，间进黑锡丹。有服诸药不效，其痛愈甚，宜茸朱丹。所以用茸者，已于《虚损》门眩晕证
详论之。（《要诀》）
少宰蒋恬庵，头痛如破，昏重不宁，风药血药痰药久治无功。余曰∶尺微寸滑，肾虚水泛为痰也。地黄
四钱，山药、丹皮、泽泻各一钱，茯苓三钱，沉香八分，日服四帖，两日辄减六七，更以七味丸人参汤送，五
日其痛若失。（《必读》）
杨树滋令妹，患头痛累月，医莫能治，延余诊之，阳脉大，阴脉涩。余曰∶此阴衰于下，阳亢于上，上
盛下虚之候也。法宜六味地黄汤加青铅五钱，俾清浊定位，斯不治痛而痛自止矣。（《印机草》）
真头痛（互见总说及降逆方中） 真痛，脉短涩，天门真痛，上引泥丸，不治；灸百会，猛进
参、沉、乌、附，或可生。（《永类》）
其或痛入泥丸，上至巅，壹点痛不可忍，六脉或绝，此由根本之气虚，谓之真头痛，旦发夕死，夕
发旦死，不可不知。（《治法秘方》）
若真头疼，则朝发夕死，夕发朝死矣（详见《难经疏》）。人而患此，亦末如之何。要之亦有所自，
其在根本不固耶。若欲着艾，须先百会、囟会等穴，而丹田、气海等穴，尤所当灸，以补养之，毋使至于此
极可也。（《资生》）
痰厥头痛（互见《水饮》中，又见后涌吐及导痰方中。并宜参。）气不顺，停痰上攻头痛，顺气
为上，二陈汤、导痰汤、并有加料法。怒气伤肝，及肺气不顺，停痰上冲于脑，令人头痛，宜沉香
降气汤并苏子降气汤，下养正丹。（《要诀》）（按∶《一万社草》有头风极痛，呕吐酸苦，以养正
丹研细，取生姜汁澄淀 滓丸用治验，文繁不录，宜参。）
蔡乐川令眷患头痛，痛如物破，发根稍动则痛延满头，晕倒不省人事，逾半时乃苏，遍身亦作疼，胸膈
饱闷，饮汤水停膈间不下，先一日吐清水数次，蛔虫三条，原为怒起，今或恶风，或恶热，口或渴或不渴，
大便秘，脉则六部皆滑大有力。予曰∶此痰厥头痛症也。先以藿香正气散止其吐，继以牛黄丸、黑虎丹清其
人事，头仍疼甚。予谓此中焦痰盛，非下不可。乃用半夏五钱，巴霜一分，面糊为丸，每服三十
丸，生姜汤送下。下午大便行三次，皆稠粘痰积也。由是饮食少进，余症瘥可。（节录）按∶原书漏注出处。
风痰头痛，多兼呕逆眩晕，若用风药，其痰愈逆，其痛益甚，《和剂》玉壶丸乃是的药，东垣变为白
术半夏天麻汤，则兼气虚而言之耳。（《金匮翼》）
脑痈 有一妇人患偏头痛，一边鼻塞，不闻香臭，常流清涕，或作臭气一阵，服遍治头痛药，加芎、
蝎皆不效，人无识此病者，或曰脑痈。偶有善医云∶但服《局方》芎犀丸（按∶龙脑芎犀丸，用龙脑、
芎、犀、栀、胶、石膏、朱砂、麦门、细辛、茯、参、甘），不十数服，忽作嚏涕，突
出一铤稠脓，其疾遂愈。（《医说》）
疮毒头痛 脉弦数，曾病梅疮而痛不止，或咽中痛，或臂膊有一块痛，属疮毒，愈毒汤多服
自止。（《六要》）
有霉疮毒发头痛，颐下左右如蚯蚓徐行入耳，顶上起疙瘩块，冷则痛甚者，山牛汤，不应作结毒
治之。（《医通》）
嗅毒头痛 嗅毒头疼，则食炒黑豆。（《续易简》）
外有臭毒头痛，一味吃炒香附愈。（《要诀》）
头腹俱痛 头与腹俱痛有五∶臭毒头痛则与腹俱痛，一味香附，煎成放凉服。伤酒伤湿亦有头腹俱
痛，但伤酒食则兼
呕逆眩晕，《外台》茯苓饮加煨葛根，伤湿则腹隐隐痛，头重不能举，羌活胜湿汤，外用瓜蒂散搐鼻。有不
伏水土头腹俱痛者，藿香正气散。有疮毒入腹，头与腹俱痛者，黄连解毒汤加腊茶。有头痛止则腹痛，腹痛
止则头痛，此属脾阴血虚，胃中有火。随气辄上辄下而然，芎、归、芍药、黄连、木香。不应，加童便、
香附、葱白。（《医通》）
死证 诊头痛目痛，久视无所见者死（久视一作卒视）。（《脉经》）
凡头痛眩晕，时时迷冒，及头目卒然大痛，目视不见，或泻多之后，皆凶证也。（《金鉴》）
治有补泻之别 世俗尝言，头无寒疼，腹无热痛，此不经之说也。黄帝问曰∶病头痛以数岁不已，
此何说？岐伯对曰∶当有所犯大寒，内至骨髓。骨者以脑为主，脑逆故令头痛，齿亦痛也。余昔治杨氏妇，
年五十余，病头痛，历岁侵久，或治以风，或治以痰，皆不效。余脉之，左寸沉迟而芤。曰∶此气血两虚也。
用当归二两，附子三钱，一服减半，二服其病如失，更不复发。用药对证，不啻影响，有如是乎。（按∶《大
还》有一妇气虚头痛，用补中益气汤大剂，加熟附子一片案，宜参。）一妇人偏头痛久不愈，医用
大承气汤即瘳何也？盖阳明燥金胜，乘肝气郁，气郁则血壅，血壅则上下不通，故燥结。以承气汤疏通之，则
气血流行而肝气通矣。《伤寒治例》云。少阳偏头痛，多便闭，宜下之。此为新病者设，若久病元气不足者，
更作处治。（《续医说》）
治有当泻火凉血 久头痛病，略感风寒便发，寒月须重绵浓帕包裹者，此属郁热，本热而标寒。
头痛是一种病证，头风是一种病名，本来不需要加以区分。有人说它们有病程新久、邪气去留的区别，这种说法是牵强附会的。
脉候：脉象紧而位于寸口的，属于中风（外感风邪），风邪引起的头痛也是如此（《千金翼方》说这也可能是伤寒引起的头痛）。脉象弦而位于寸口的，属于宿食停滞，脉象沉的则引起头痛。如果病人出现头痛、目痛，但脉象反而短涩，这是死证。（《脉经》）
头痛见短涩脉应当主死，脉浮滑者多为风痰，容易治愈。（《脉诀》）
头痛脉象阳部见弦脉，浮脉主风，紧脉主寒，洪数脉主风热，细坚脉主湿。气虚引起的头痛，脉虽弦但必涩；痰厥引起的头痛，脉滑；肾厥引起的头痛，脉坚实。（《崔氏脉诀》）
痰厥的脉象，时而伏匿，时而显现。（《医学大成》）
脑痛，脉象缓大的，主死。（《丹溪心法》）
源由证治总说：头面部的风邪致病，是因为人体正气虚弱，诸阳经脉被风邪侵袭。诸阳经脉都上行至头面部，若因运动劳役导致阳气发泄，腠理（皮肤毛孔）张开而受风，称为首风。（此处原文列举经文，不录。）另外，刚洗完头头发未干时，不可以躺卧，否则会使头重身热。若再受风，则会感到烦闷。诊察其脉象，寸口脉的阴阳表里之气互相乘侮。如果风邪在头部停留，久不痊愈，风邪就会入脑，变为头眩。（《诸病源候论》）
所谓风邪头痛，大凡人体正气虚弱，外感风邪，风邪流入阳经，行于六腑，或者腠理开张，风毒攻注于风府穴，导致心膈烦热，头面出虚汗，气机上壅滞，所以导致头重疼痛。（《太平圣惠方》）
头部是诸阳经汇聚的地方，凡是头痛，都是足太阳膀胱经受病。疼痛向上连及风府穴和眉角的，都可以用药治愈。如果疼痛向上穿透风府穴，隐入泥丸宫（指脑部深处），这叫做真头疼，不可以用药治愈，晚上发作早上死，早上发作晚上死，这是因为根本元气先绝所致。探究其原因，有的因中受风寒暑湿而疼，有的因气血饮食厥逆而疼，有的因五脏气郁厥逆而疼。治疗的方法，应当先审察这三种病因，三因明确后，施治就没有不切中的。（《三因极一病证方论》）
头痛不是一种类型，有风冷头痛，痰厥头痛，肾厥头痛，积滞头痛，气虚头痛，偏正头痛，嗅毒头痛，伤寒头痛，膈痰风厥头痛，更有夹脑风、洗头风，治疗各有方剂。（《续易简方》）
人的头部，是诸阳经气血汇聚之处。诸阴经脉都到达颈部就返回，只有诸阳经脉都上行至头部和耳部，由此可知头面部都属于阳部。况且平时的人，阳气顺行于上而不逆乱，就不会有头痛的祸患。阳气逆乱于上而不顺，冲撞壅塞于头部，所以发生头痛。风寒在脑，邪热上攻，痰厥肾厥，气虚气逆上攻，都会导致头痛。但是气虚气逆引起的头痛，治愈后又复发，拖延岁月的情况有很多。偏正头风，妇女气盛血虚，产后失血过多，气无所主，都会导致头痛。（《济生方续集》）
足太阳膀胱经，是头部的经络。六经伤寒中，只有太阳经受病最多。因为头居身体上部，正对着风寒侵袭的方向，一旦有间隙，无论是头顶、脑部，还是耳朵、鼻子，风邪都能乘虚而入，何况还有梳洗取凉、饱食仰卧等不加谨慎的情况呢。头风作为疾病，不一定必须有偏头痛或正头痛的症状，只要是从颈项以上，耳目口鼻眉棱之间，有一处感觉不适于身体的常态，都是头风的征兆。有的头痛，有的头晕，有的头皮麻木不知痛痒，有的口舌麻木不知滋味，或者耳聋，或者头汗，或者目痛，或者眉棱上下牵引作痛，或者鼻中闻香觉得极香，闻臭觉得极臭，或者只是打呵欠而呈现昏冒眩晕的状态，凡此种种都是头风证。治疗的大要，有热证的用消风散，用防风、荆芥煎汤送服。无热证的用追风散（含有川乌、石膏等大辛大热之品，难以普遍适用），用薄茶清送下。又有素来患有头风的人，或因伤于风寒暑湿，根据证候调理后获得轻安，不久头风又发作，就不必拘泥于前面的药物，应当用头风和平之剂治疗。如果病人身体老弱，先患头风，又感受寒邪，自汗不止，这种情况下用药，没有附子是不行的。（妇女月经期间，敢用梳篦梳头，多形成头风痒痛，满头如水泡状。）（《直指方》）
头痛不止，是三阳经受病，三阳经各分部分。头和项部疼痛的，是足太阳膀胱经的病。攒竹穴痛，俗称眉棱骨痛的，是阳明经的病。额角上方疼痛，俗称偏头痛的，是少阳经的病。如果疼痛长久不愈，会使人失明。因为三阳经受病，都是由胸膈有宿痰导致的，先用茶调散催吐，后用香薷散、白虎汤投服就能痊愈。然而头痛不止，可以煎葱白须、豆豉汤催吐，吐完后可以服用川芎、薄荷，辛凉清上，搜风丸、香芎散（均见于《三法六门》）之类的药物。（《治病百法》）
内因引起的头痛，时发时止；外因引起的头痛，常常存在。（《永类钤方》）
各种头痛有六种证候：伤风，头痛或半边偏痛，都是因为冷风吹袭，遇风冷则发作，脉象寸部浮的是。食积，因为胃中有阴冷宿食不化，上冲引起头痛，右手脉浮紧严重的是。（按：《六要》说：右关寸脉滑而实，证候兼有呕吐恶心，心下痞闷或痛，或寒热如疟疾，这是食郁头痛，治疗需要消导。）气虚，因为下部气虚上攻，隐隐作痛，不同于邪毒所攻，脉象尺部虚浮的是。伤寒，在太阳经，其痛如破，关前脉数是，紧数是。阳明经胃热上攻，右关脉洪大而数是。（按：《金匮翼》说：热厥头痛，是胃热气盛，不能下行。证候是头中热痛，即使在严冬也喜欢风寒，稍微到暖处或见到烟火，疼痛就复发，脉象数或大的是。）膈上有风涎冷痰而有时呕吐，脉象弦细出于寸口的是。（《丹溪心法》）
血虚头痛，从鱼尾（太阳穴附近）上攻引起头痛，用芎归汤，古方有用追涎药。（同上）
头部是清阳之分，外有六淫邪气相侵，内有脏腑经脉邪气上逆，都能扰乱清气，相互搏击导致疼痛，必须分辨内外虚实。实证，其人血气本不虚，被外邪侵犯，或者遮蔽复盖其清明，或者壅塞其经络，或者内部实火上炎，因而血瘀涎滞，不得通行而痛，其痛必然剧烈，这叫实。虚证，其人气血本虚，被外邪侵犯，或者内部浊阴上干，虽然也是血瘀涎滞不能通行，但搏击无力，其痛不剧烈，这叫虚。（《准绳》说真气虚寒，遇到外来的寒湿侵袭，血涩脉寒，卷缩紧急，牵引小络而痛，得暖则痛止。）（按：这段全文也是基于《准绳》而加以删订的。所引的文句则是取自《举痛论》。）实证，邪气实而正气不虚，可以承受攻伐。虚证，正气自虚而邪气自实，补正的同时仍需治邪。如果邪气也不实，只需补正，邪气自然退去。（《医碥》）
因风而痛的，抽搐掣痛，恶风，有汗且痛。因暑热而痛的，或有汗，或无汗，都恶热且痛。因湿而痛的，痛而头重，遇阴天尤其严重。因痰饮而痛的，也头昏重而痛，心中烦闷欲吐。因寒而痛的，恶寒且脉绌急（收缩紧急）。气虚而痛的，遇劳累则痛甚，脉大。血虚而痛的，善惊惕，脉芤。（《金匮翼》）（按：这是《准绳》的节文。《翼》更将头痛分为十一类：曰风，曰热厥，曰湿热，曰寒湿，曰痰厥，曰肾虚，曰肝厥，曰食积，曰血虚，曰气虚，曰偏。）
血虚头痛，必有烦躁、发渴、身热等表现，脉必涩而虚，产后金疮失血的病人多有此症，虽然宜补血，又必须兼养其气，因为血非气不生。如果阴虚水亏，火动而痛，宜用沉阴至静之品，补水以制其火，尤其不宜过用川芎、当归，助其升散。气虚头痛，必有倦怠少食、或畏寒、或羞明等表现，脉必微而细，或大而空，也有久病年高的人有此症，必须在补气之中，兼用姜、桂以扶助阳气，少佐川芎、细辛以通达气机。痰厥头痛，必有呕恶、胸满、咳嗽、气逆、多痰等证候。脉必弦而滑。又有火邪头痛，虽然各经都能为害，但以阳明经最为严重，因为阳明胃火盛于头面，直达头维穴，所以其痛必甚，脉必洪，证必口渴躁热，宜用知母、花粉、生地、麦冬、甘草之类，以抑阳而生阴，严重时用白虎汤，以迎秋气而却炎威，效果最快。（《汇论》）
头痛：挟风寒的，忌用补敛，宜用辛温发散。挟邪热的，忌同挟风寒者一样，宜用辛寒、苦寒、解散。挟痰的，忌用升提、补敛、酸甘、滞腻，宜用豁痰降气、辛燥。阴虚的，忌用辛热发散，宜用补血益阴、甘寒、酸寒。（《本草经疏》）
病因肾虚（肝虚眩晕肾虚证治）：《素问》说：头痛巅疾，下虚上实，病在足少阴肾经和足太阳膀胱经，严重的则入肾。徇蒙招摇（视物模糊摇晃），目瞑耳聋，下实上虚，病在足少阳胆经和足厥阴肝经，严重的则入肝。下虚是指肾虚，所以肾虚则头痛。（按：原书以玉真丸为主，现举降逆方中内容。）上虚是指肝虚，所以肝虚则头晕。徇蒙，像是有东西蒙住头部。招摇不定，目眩耳聋，都是晕的状态。所以肝厥头晕、肾厥巅痛不同如此。（《本事方》）
肾虚，耳鸣面黑小便多，用真黑锡丹，煎苏子降气汤送服，或用沉附汤、术附汤加川芎、细辛。（《永类钤方》）
因虚头痛，这是肾厥头痛，宜用正元散（见《和剂局方》，含乌头、附子等大辛大热之品），或大三五七散加盐煎服，或在正元散内加入炒花椒十五粒和下来复丹，间服黑锡丹。有服用各种药物无效，疼痛加剧的，宜用茸朱丹。之所以用鹿茸，已在《虚损》门眩晕证中详细论述过。（《要诀》）
少宰蒋恬庵，头痛如破，昏重不宁，用风药、血药、痰药久治无功。我说：尺脉微，寸脉滑，是肾虚水泛为痰。用地黄四钱，山药、丹皮、泽泻各一钱，茯苓三钱，沉香八分，每日服四帖，两天减轻六七成，再用七味丸人参汤送服，五天疼痛消失。（《必读》）
杨树滋的妹妹，患头痛累月，医生不能治愈，请我诊治，阳脉大，阴脉涩。我说：这是阴衰于下，阳亢于上，上盛下虚的征候。治法宜用六味地黄汤加青铅五钱，使清浊定位，这样不治痛而痛自止。（《印机草》）
真头痛（互见总说及降逆方中）：真痛，脉短涩，天门真痛，疼痛上引泥丸宫，不治；灸百会穴，猛进人参、沉香、乌头、附子，或许能活。（《永类钤方》）
如果疼痛深入泥丸宫，上至头顶，一点疼痛不可忍受，六脉或绝，这是由于根本之气虚，叫做真头痛，早晨发作晚上死，晚上发作早晨死，不可不知道。（《治法秘方》）
如果是真头疼，则早晨发作晚上死，晚上发作早晨死（详见《难经疏》）。人患此病，也无能为力。总之也是有原因的，在于根本不固吧。如果想用艾灸，必须先灸百会、囟会等穴，而丹田、气海等穴，更是应当灸的，以补养元气，不要使之发展到这种极端程度就可以了。（《资生经》）
痰厥头痛（互见《水饮》中，又见后涌吐及导痰方中。并宜参。）：气不顺，停痰上攻头痛，以顺气为上策，二陈汤、导痰汤，并有加料法。怒气伤肝，及肺气不顺，停痰上冲于脑，令人头痛，宜用沉香降气汤并苏子降气汤，送服养正丹。（《要诀》）（按：《一万社草》记载头风极痛，呕吐酸苦，用养正丹研细，取生姜汁澄淀去滓制丸使用有效，文字繁琐不录，宜参考。）
蔡乐川的妻子患头痛，痛如物破，发根稍动则痛延满头，晕倒不省人事，过半时才苏醒，遍身亦作疼，胸膈饱闷，饮汤水停膈间不下，前一天吐清水数次，吐出蛔虫三条，起因为怒，现在或恶风，或恶热，口或渴或不渴，大便秘，脉象六部皆滑大有力。我说：这是痰厥头痛症。先用藿香正气散止其呕吐，继以牛黄丸、黑虎丹清其神志，头仍疼甚。我说这是中焦痰盛，非用下法不可。于是用半夏五钱，巴豆霜一分，面糊为丸，每服三十丸，生姜汤送下。下午大便行三次，都是稠粘痰积。从此饮食稍进，其余症状好转可愈。（节录）按：原书漏注出处。
风痰头痛，多兼呕逆眩晕，如果用风药，其痰愈逆，其痛益甚，《和剂局方》的玉壶丸才是对症的药，东垣将其变为白术半夏天麻汤，则是兼气虚而言的罢了。（《金匮翼》）
脑痈：有一个妇人患偏头痛，一边鼻塞，不闻香臭，常流清涕，有时散发一阵臭气，服遍治头痛药，加川芎、全蝎都不见效，无人认识此病，有人说这是脑痈。偶然有个善于医术的人说：只服《局方》芎犀丸（按：龙脑芎犀丸，用龙脑、川芎、犀角、栀子、阿胶、石膏、朱砂、麦门冬、细辛、茯苓、人参、甘草），不到十服药，忽然打喷嚏流鼻涕，突然排出一铤稠脓，疾病遂愈。（《医说》）
疮毒头痛：脉弦数，曾患梅毒而痛不止，或咽中痛，或臂膊有一块痛，属于疮毒，多服愈毒汤自然停止。（《六要》）
有霉疮毒发头痛，颐下左右如蚯蚓徐行入耳，顶上起疙瘩块，冷则痛甚的，用山牛汤，不应验则按结毒治疗。（《医通》）
嗅毒头痛：嗅毒头疼，则吃炒黑豆。（《续易简方》）
外有臭毒头痛，一味吃炒香附即可痊愈。（《要诀》）
头腹俱痛：头与腹俱痛有五种：臭毒头痛则与腹俱痛，一味香附，煎成放凉服。伤酒伤湿也有头腹俱痛，但伤酒食则兼有呕逆眩晕，《外台秘要》茯苓饮加煨葛根；伤湿则腹隐隐痛，头重不能举，用羌活胜湿汤，外用瓜蒂散搐鼻。有不适应水土导致头腹俱痛的，用藿香正气散。有疮毒入腹，头与腹俱痛的，用黄连解毒汤加腊茶。有头痛止则腹痛，腹痛止则头痛，这属于脾阴血虚，胃中有火。随气辄上辄下而然，用川芎、当归、芍药、黄连、木香。不应验，加童便、香附、葱白。（《医通》）
死证：诊察头痛目痛，久视无所见的死（久视一作卒视）。（《脉经》）
凡头痛眩晕，时时迷冒，及头目卒然大痛，目视不见，或泻多之后，都是凶证。（《医宗金鉴》）
治有补泻之别：世俗常说，头无寒疼，腹无热痛，这是不经之谈。黄帝问：病头痛多年不愈，这是什么道理？岐伯回答：应当有所犯大寒，内至骨髓。骨以脑为主，脑气逆故令头痛，牙齿也痛。我以前治疗杨姓妇人，五十多岁，患头痛，历时很久，有的用风药治，有的用痰药治，都不见效。我诊其脉，左寸沉迟而芤。说：这是气血两虚。用当归二两，附子三钱，一服减半，二服其病如失，不再复发。用药对证，不啻影响，有像这样的吗。（按：《大还》记载有一妇人气虚头痛，用补中益气汤大剂，加熟附子一片，宜参考。）一个妇人偏头痛久不愈，医生用大承气汤即愈，为什么呢？盖因阳明燥金胜，乘克肝气郁，气郁则血壅，血壅则上下不通，故燥结。以承气汤疏通之，则气血流行而肝气通矣。《伤寒治例》说：少阳偏头痛，多便闭，宜下之。这是为新病者设的，若久病元气不足者，另作处治。（《续医说》）
治有当泻火凉血：久头痛病，略感风寒便发，寒月须重绵浓帕包裹的，这属于郁热，本热而标寒。
Headache is a syndrome (bing zheng), while Tou Feng (Head Wind) is a disease name; originally, there was no need to distinguish between them. Some argue that they differ in terms of new versus chronic duration and the retention or departure of pathogenic factors, but this view is far-fetched.
Pulse Diagnosis: A tight pulse at the Cun position indicates Wind Strike (Zhong Feng, illness caused by external wind pathogens); headache due to wind pathogens presents similarly (Qianjin Yi Fang states this may also be headache due to Shang Han [Cold Damage]). A wiry pulse at the Cun position indicates retained food stagnation; a deep pulse causes headache. If a patient presents with headache and eye pain, but the pulse is instead short and choppy, it indicates death (Mai Jing).
Headache with a short and choppy pulse indicates death; floating and slippery pulses indicate wind-phlegm, which is easy to eliminate (Mai Jue).
In headache, a wiry pulse in the Yang positions indicates wind; floating indicates wind; tight indicates cold; surging and rapid indicate wind-heat; fine and firm indicates dampness. Headache due to Qi deficiency, though wiry, must be choppy; headache due to Phlegm Jue (Phlegm-induced reversal) presents with a slippery pulse; headache due to Kidney Jue presents with a firm and solid pulse (Cui Shi Mai Jue).
The pulse of Phlegm Jue appears intermittently, sometimes hidden and sometimes visible (Yi Xue Da Cheng).
Brain pain with a slow and large pulse indicates death (Dan Xi Xin Fa).
General Discussion on Etiology, Symptoms, and Treatment:
Wind affecting the head and face occurs because the body's healthy Qi is deficient, allowing wind pathogens to invade the Yang meridians. All Yang meridians ascend to the head and face. When physical exertion causes Yang Qi to dissipate and the Cou Li (skin pores) open, wind invades; this is called Shou Feng (First Wind). (Original scriptures listed below are omitted.) Furthermore, one should not lie down with wet hair after washing, as this causes heavy head and hot body. If wind is contracted subsequently, it leads to irritability and oppression. Pulse diagnosis reveals mutual invasion of Yin-Yang and exterior-interior energies at the Cun position. If wind remains in the head and does not resolve for a long time, it enters the brain, transforming into Xuan Yun (Vertigo/Dizziness) (Bing Yuan Lun).
Regarding Wind Headache: Generally, when the body is deficient and externally invaded by wind pathogens, the wind flows into the Yang meridians and travels through the Six Fu organs. If the Cou Li are open, wind-toxin attacks the Fengfu acupoint, causing irritability and heat in the heart and diaphragm, empty sweating on the head and face, and upward congestion, resulting in heavy and painful head (Tai Ping Sheng Hui Fang).
The head is the gathering point of all Yang meridians. In cases of headache, it is primarily the Foot-Taiyang Bladder Meridian that is affected. Pain extending upward to connect with Fengfu and the eyebrow angle can be cured with medicine. However, if pain penetrates upward through Fengfu and hides in the Ni Wan Palace (deep brain region), it is called Zhen Tou Tong (True Headache), which cannot be cured by medicine; death occurs from evening to morning or morning to evening, because the root Qi has failed first. Investigating the causes, pain may result from contracting wind-cold-warmth-dampness, from Qi-Blood-Food-Drink Jue (reversal), or from Five Zang organ Qi depression Jue. The treatment method requires first examining these three categories of causes; once clear, treatment will hit the mark accurately (San Yin Ji Yi Bing Zheng Fang Lun).
Headache is not a single type; there are wind-cold headache, phlegm-Jue headache, kidney-Jue headache, accumulation-stagnation headache, Qi-deficiency headache, lateral-and-central headache, odor-toxin headache, Shang Han headache, diaphragm-phlegm wind-Jue headache, and additionally Jia Nao Feng (Brain-clasping Wind) and Xi Tou Feng (Washing-head Wind), each treated with specific formulas (Xu Yi Jian Fang).
The human head is where Yang Qi gathers. All Yin meridians reach the neck and return, whereas all Yang meridians ascend to the head and ears; thus, the head and face belong to the Yang portion. Normally, Yang Qi moves smoothly upward without rebellion, so there is no headache. When Yang Qi rebels upward and becomes obstructed, it congests the head, causing headache. Wind-cold in the brain, evil-heat attacking upward, phlegm-Jue, kidney-Jue, and Qi-deficiency with Qi attacking upward all cause headache. However, headache due to Qi-deficiency and Qi-attack often recurs after healing and drags on for years. Lateral and central Tou Feng often occur in women with abundant Qi and deficient Blood, or after postpartum excessive blood loss where Qi has no master, all leading to headache (Ji Sheng Xu Ji).
The Foot-Taiyang is the meridian of the head. Among the Six Meridians in Shang Han, the Taiyang is most frequently affected. Since the head is at the top, it faces the direct impact of wind and cold; any gap allows wind pathogens to enter the crown, brain, ears, or nose, especially given careless habits like bathing for coolness or lying supine after full meals. Tou Feng as a disease does not necessarily present with lateral or central headache symptoms; rather, any discomfort in the area from the neck upwards—including eyes, ears, mouth, nose, and brow ridge—indicates its progression. Symptoms include headache, dizziness, scalp numbness (unaware of sensation), oral/tongue insensitivity (loss of taste), deafness, head sweating, eye pain, pulling pain above and below the brow ridge, extreme sensitivity to smells (fragrant smells seem extremely fragrant, foul smells extremely foul), or merely yawning accompanied by vertigo. All these are Tou Feng syndromes. General treatment principles: For heat syndromes, use Xiao Feng San (Wind-Expelling Powder), taken with decoction of Fang Feng (Saposhnikovia Root) and Jing Jie (Schizonepeta Herb). For non-heat syndromes, use Zhui Feng San (containing Chuan Wu [Aconite Root] and Shi Gao [Gypsum], difficult to apply universally), taken with weak tea infusion. For those chronically suffering from Tou Feng who, after recovering from wind-cold-warmth-dampness, suffer a relapse, do not stick rigidly to previous prescriptions; instead, use a harmonizing formula for Tou Feng. If an elderly or weak patient, already suffering from Tou Feng, contracts cold pathogens and experiences continuous spontaneous sweating, Fuzi (Prepared Aconite Root) is indispensable. (Women who comb their hair during menstruation often develop Tou Feng with itching and pain, resembling water blisters on the head) (Zhi Zhi Fang).
Persistent headache involves the Three Yang meridians, each occupying specific regions. Pain in the head and nape belongs to the Foot-Taiyang Bladder Meridian. Pain at Cuanzhu acupoint, commonly called brow ridge pain, belongs to the Yangming Meridian. Pain at the upper temple, commonly called lateral headache, belongs to the Shaoyang Meridian. If pain persists for a long time, it can cause blindness. This is caused by old phlegm in the chest and diaphragm due to the Three Yang meridians being diseased. First induce vomiting with Cha Tiao San (Tea Regulating Powder), then treat with Xiang Ru San (Elsholtzia Powder) and Bai Hu Tang (White Tiger Decoction) for recovery. However, for persistent headache, one can decoct Cong Bai Xu (Scallion White Stalks) and Dou Chi (Fermented Soybean) to induce vomiting; after vomiting, administer Chuan Xiong (Ligusticum Rhizome) and Bo He (Mint Leaf), pungent-cool to clear the upper burner, along with Sou Feng Wan (Wind-Hunting Pill) or Xiang Xiong San (see San Fa Liu Men) (Zhi Bing Bai Fa).
Internal-cause headaches come and go; external-cause headaches are constant (Yong Lei Qian Fang).
There are six types of headache:
1. Wind-Cold: Headache or unilateral pain caused by cold wind exposure, triggered by cold; Cun pulse is floating.
2. Food Accumulation: Cold undigested food in the stomach rushes upward causing headache; Right hand pulse is floating, tight, and severe. (Note: Liu Yao states: Slippery and solid Right Guan/Cun pulses, with vomiting/nausea, epigastric fullness/pain, or alternating chills/fever, indicate Food-Stagnation Headache; treatment requires digestion-promoting methods.)
3. Qi Deficiency: Lower-body Qi deficiency rushing upward causes dull pain, distinct from toxin attack; Chi pulse is deficient and floating.
4. Shang Han: In the Taiyang meridian, pain feels like breaking; Guan-front pulse is rapid or tight-rapid.
5. Yangming Meridian Stomach Heat: Stomach heat rushes upward; Right Guan pulse is surging, large, and rapid. (Note: Jin Kui Yi states: Heat-Jue headache is due to excess Stomach Qi-Heat failing to descend. Symptoms include heat-pain in the head, preference for wind/cold even in winter, recurrence upon entering warmth or seeing fire/smoke; pulse is rapid or large.)
6. Diaphragm Wind-Saliva/Cold-Phlegm: Occasional vomiting; pulse is wiry and fine at the Cun position (Dan Xi Xin Fa).
Blood-Deficiency Headache: Pain attacking from the fish-tail (temple area) is treated with Xiong Gui Tang (Ligusticum and Angelica Decoction); ancient formulas use phlegm-expelling medicines (ibid.).
The head is the domain of Clear Yang. External invasion by Six Evils or internal rebellion of Zang-Fu/Meridian pathogens disrupts Clear Yang, causing conflict and pain. One must distinguish interior/exterior and deficiency/excess.
Excess: The person's Qi-Blood is fundamentally sound but invaded by external pathogens, obscuring clarity or blocking meridians, or internal Excess Fire flares up, causing Blood stasis and Phlegm stagnation preventing circulation, resulting in severe pain. This is Excess.
Deficiency: The person's Qi-Blood is fundamentally deficient. Invaded by external pathogens or internal Turbid Yin rising, although Blood stasis and Phlegm stagnation prevent circulation, the conflict lacks force, resulting in mild pain. This is Deficiency. (Zhun Sheng states: True Qi deficiency and cold, invaded by external cold-dampness, causes sluggish Blood and cold pulses, leading to contraction and tension of small collaterals and pain, relieved by warmth.) (Note: This text is adapted from Zhun Sheng, citing Ju Tong Lun.) In Excess, Evil is strong and Healthy Qi is not weak, so attack is tolerated. In Deficiency, Healthy Qi is weak and Evil is relatively strong; tonifying Healthy Qi still requires treating Evil. If Evil is not strong, tonifying Healthy Qi alone causes Evil to recede (Yi Que).
Headache due to Wind: Pulling pain, aversion to wind, sweating with pain.
Headache due to Summer-Heat: With or without sweating, always aversion to heat with pain.
Headache due to Dampness: Pain with heavy head, worse on cloudy days.
Headache due to Phlegm-Fluid: Dizzy, heavy, painful, with nausea/desire to vomit.
Headache due to Cold: Aversion to cold with constricted/tight pulse.
Headache due to Qi Deficiency: Worse with labor, large pulse.
Headache due to Blood Deficiency: Prone to fright/startle, knotted pulse (Jin Kui Yi). (Note: This is an excerpt from Zhun Sheng. Yi divides headache into eleven categories: Wind, Heat-Jue, Damp-Heat, Cold-Damp, Phlegm-Jue, Kidney Deficiency, Liver-Jue, Food Accumulation, Blood Deficiency, Qi Deficiency, Lateral.)
Blood-Deficiency Headache: Must have irritability, thirst, body heat; pulse is choppy and deficient. Common after childbirth or traumatic bleeding. Although blood tonification is needed, Qi must also be nourished, as Blood does not generate without Qi. If Yin deficiency with Water depletion causes Fire agitation and pain, use heavy, yin, tranquilizing herbs to nourish Water to control Fire; avoid overusing Chuan Xiong and Dang Gui to prevent ascending dispersion.
Qi-Deficiency Headache: Must have fatigue, poor appetite, aversion to cold, or photophobia; pulse is faint and fine, or large and empty. Common in chronic illness or elderly. Tonify Qi while using Jiang (Ginger) and Gui (Cinnamon Twig) to support Yang, and add small amounts of Chuan Xiong and Xi Xin to guide Qi.
Phlegm-Jue Headache: Must have nausea/vomiting, chest fullness, cough, rebellious Qi, excessive phlegm; pulse is wiry and slippery.
Fire-Evil Headache: Although all meridians can be involved, Yangming is most severe because Stomach Fire is abundant in the head/face, reaching directly to Toubwei acupoint. Pain is severe, pulse is surging, symptoms include thirst and restlessness. Use Zhi Mu (Anemarrhena Rhizome), Hua Fen (Tienchufan Root), Sheng Di Huang (Rehmannia Root), Mai Dong (Ophiopogon Tuber), Gan Cao (Licorice Root) to suppress Yang and generate Yin. Severe cases use Bai Hu Tang to counteract summer heat, yielding fastest results (Hui Lun).
Headache:
With Wind-Cold: Avoid tonifying/astringing; use Pungent-Warm dispersants.
With Evil-Heat: Do not treat like Wind-Cold; use Pungent-Cool/Bitter-Cool dispersants.
With Phlegm: Avoid lifting, tonifying, astringing, sour-sweet, or cloying herbs; use Phlegm-resolving/Qi-descending/Pungent-Dry herbs.
With Yin Deficiency: Avoid Pungent-Warm dispersants; use Blood-tonifying/Yin-nourishing/Sweet-Cool/Sour-Cool herbs (Ben Cao Jing Shu).
Etiology: Kidney Deficiency (Liver Deficiency Vertigo/Kidney Deficiency Syndrome Treatment):
Su Wen states: Headache and cranial diseases, lower deficiency and upper excess, involve Foot-Shaoyin (Kidney) and Foot-Taiyang (Bladder); severe cases enter the Kidney. "Xun Meng Zhao Yao" (blurred vision/swaying), closed eyes, deafness, upper deficiency and lower excess, involve Foot-Shaoyang (Gallbladder) and Foot-Jueyin (Liver); severe cases enter the Liver. Lower deficiency refers to Kidney Deficiency, hence Kidney Deficiency causes headache. Upper deficiency refers to Liver Deficiency, hence Liver Deficiency causes dizziness. "Xun Meng" means feeling as if covered by something. Swaying, dizziness, deafness are signs of vertigo. Thus, Liver-Jue dizziness and Kidney-Jue cranial pain are different (Ben Shi Fang).
Kidney Deficiency: Tinnitus, black complexion, frequent urination. Use Zhen Hei Xi Dan (True Black Tin Pill), taken with Su Zi Jiang Qi Tang (Perilla Seed Descending-Qi Decoction), Chen Fu Tang (Aucklandia and Aconite Decoction), or Zhu Fu Tang (Atractylodes and Aconite Decoction) plus Chuan Xiong and Xi Xin (Yong Lei Qian Fang).
Deficiency Headache (Kidney-Jue Headache): Use Zheng Yuan San (contains Wu Tou and Fu Zi), or Da San Wu Qi San with salt decocted, or Zheng Yuan San with 15 fried Sichuan peppercorns and Lai Fu Dan, alternating with Hei Xi Dan. If all medicines fail and pain worsens, use Rong Zhu Dan. The use of Rong (Deer Antler) is discussed in detail under Vertigo in the Deficiency category (Yao Jue).
Case: Jiang Tian'an, Vice Minister, suffered headache like breaking, heavy dizziness, unquiet. Wind, Blood, and Phlegm medicines failed for a long time. I said: Chi pulse is faint, Cun pulse is slippery; this is Kidney Deficiency with Water overflowing to create Phlegm. Use Di Huang 4 qian, Shan Yao, Dan Pi, Ze Xie 1 qian each, Fu Ling 3 qian, Chen Xiang 8 fen. Four doses daily. Reduced by 60-70% in two days. Then administered Qi Wei Wan (Seven-Ingredient Pill) with Ren Shen (Ginseng) soup. Pain disappeared in five days (Bi Du).
Case: Sister of Yang Shuzi suffered headache for months, untreatable by others. I diagnosed: Yang pulse large, Yin pulse choppy. I said: This is Yin decline below, Yang hyperactivity above, Excess above and Deficiency below. Method: Liu Wei Di Huang Tang (Six-Ingredient Rehmannia Decoction) plus Qing Qian (Lead Oxide) 5 qian, to settle Clear and Turbid, thus stopping pain without directly treating it (Yin Ji Cao).
True Headache (See General Discussion and Descending-Qi Formulas): True pain, short/choppy pulse, Tianmen True Headache, pain radiating to Ni Wan Palace, untreatable; moxa Baihui acupoint, aggressively administer Ren Shen, Chen Xiang, Wu Tou, Fu Zi, possibly survival (Yong Lei Qian Fang).
If pain enters Ni Wan Palace, ascends to the vertex, unbearable pinpoint pain, six pulses vanish, this is due to fundamental Qi deficiency, called True Headache; morning onset evening death, evening onset morning death, must know this (Zhi Fa Mi Fang).
If True Headache, morning onset evening death, evening onset morning death (see Nan Jing Shu). No remedy exists. It stems from insecure root. If using moxibustion, must first moxa Baihui, Xinhui acupoints, and especially Dantian, Qihai acupoints to tonify, avoiding such extremity (Zi Sheng).
Phlegm-Jue Headache (See Fluids, Vomiting, and Phlegm-Resolving Formulas. Refer also.): Disordered Qi, stagnant Phlegm attacking head causing headache; regulating Qi is primary. Er Chen Tang, Dao Tan Tang, with modifications. Anger injuring Liver, Lung Qi disorder, stagnant Phlegm rushing to brain causing headache: use Chen Xiang Jiang Qi Tang and Su Zi Jiang Qi Tang, taken with Yang Zheng Dan (Yao Jue). (Note: Yi Wan She Cao records extreme Tou Feng with sour/bitter vomiting, treating with Yang Zheng Dan powder mixed with Ginger juice clarified pills, effective; text omitted for brevity, refer.)
Case: Wife of Cai Lechuan suffered headache, pain like breaking, slight movement of hair roots spread pain to whole head, fainted unconscious, recovered after half hour, body ache, chest/oppression, fluids stuck in diaphragm, vomited clear water several times prior, expelled 3 roundworms, started from anger, now aversion to wind/heat, thirst/no thirst, constipation, all six pulses slippery/large/powerful. I said: Phlegm-Jue Headache. First use Huo Xiang Zheng Qi San to stop vomiting, then Niu Huang Wan, Hei Hu Dan to clear spirit. Headache persisted. I said: Middle Jiao Phlegm excess, requires purging. Used Ban Xia 5 qian, Ba Shi (Croton Seed Paste) 1 fen, dough pills, 30 pills per dose, Ginger soup wash down. Three stools afternoon, thick sticky phlegm accumulation. Diet improved, other symptoms resolved (Excerpt). Note: Original book missing source citation.
Wind-Phlegm Headache: Often accompanied by vomiting/reversal and vertigo. Using Wind medicines makes Phlegm more rebellious and pain worse. He Ji Ju Fang's Yu Hu Wan is the correct medicine. Dong Yuan transformed it into Bai Zhu Ban Xia Tian Ma Tang, referring to Qi deficiency (Jin Kui Yi).
Brain Abscess: A woman suffered lateral headache, one side nasal congestion, loss of smell, clear discharge, occasional foul odor. All headache medicines plus Chuan Xiong and Quan Xie failed. No one recognized the disease; some said Brain Abscess. An expert physician said: Take Ju Fang Xiong Xi Wan (Long Nao Xiong Xi Wan: Long Nao [Borneol], Chuan Xiong, Xi Jiao [Rhinoceros Horn], Zhi Zi [Gardenia], E Jiao [Donkey-hide Gelatin], Shi Gao [Gypsum], Zhu Sha [Cinnabar], Mai Men Dong [Ophiopogon], Xi Xin [Asarum], Fu Ling [Poria], Ren Shen [Ginseng], Gan Cao [Licorice]). Within ten doses, suddenly sneezed/discharge, expelled a rod of thick pus, disease cured (Yi Shuo).
Sores-Toxin Headache: Wiry-rapid pulse, history of Syphilis, pain unceasing, or throat pain, or arm pain patch, belongs to Sores-Toxin. Take Yu Du Tang (Toxin-Resolving Decoction) frequently until stopped (Liu Yao).
Syphilis-Toxin Headache: Swelling below jaw moving like earthworm into ear, nodules on vertex, cold aggravates pain. Use Shan Niu Tang; if ineffective, treat as Knot-Toxin (Yi Tong).
Odor-Toxin Headache: Eat fried black beans (Xu Yi Jian Fang).
External Stench-Toxin Headache: Eat fried Xiang Fu (Cyperus Rhizome) alone to cure (Yao Jue).
Head and Abdomen Simultaneous Pain: Five types.
1. Stench-Toxin Headache with abdomen pain: Fried Xiang Fu decocted, cooled, taken.
2. Alcohol/Dampness injury with head/abdomen pain: Alcohol/Food injury adds vomiting/vertigo; Waitai Fu Ling Yin plus Wei Ge Gen (Kudzu Root). Dampness injury adds dull abdominal pain, heavy head unable to lift; Qiang Huo Sheng Shi Tang, external Gua Di San (Melon Spittle Powder) insufflated into nose.
3. Acclimatization pain: Huo Xiang Zheng Qi San.
4. Sores-Toxin entering abdomen: Huang Lian Jie Du Tang plus La Cha (Preserved Tea).
5. Headache stops then abdominal pain starts, vice versa: Spleen Yin/Blood deficiency, Stomach Fire. Qi moves up/down. Use Chuan Xiong, Dang Gui, Bai Shao, Huang Lian, Mu Xiang. If ineffective, add Tong Bian (Child Urine), Xiang Fu, Cong Bai (Scallion White) (Yi Tong).
Death Syndromes: Diagnosing headache and eye pain, unable to see after prolonged gazing indicates death (prolonged gazing alternatively sudden gazing) (Mai Jing).
Any headache with vertigo, frequent confusion/fainting, sudden severe head/eye pain, blindness, or after profuse diarrhea, are ominous signs (Yi Zong Jin Jian).
Treatment Distinction Between Tonifying and Purging:
Secular saying "No cold headache, no hot abdominal pain" is incorrect.
Yellow Emperor asked: Headache persisting for years, why?
Qibo answered: Likely contracted severe Cold, penetrating to Marrow. Bone houses Brain; Brain Qi rebellion causes headache and toothache.
I once treated Mrs. Yang, 50+, chronic headache. Wind/Phlegm treatments failed. Pulse: Left Cun deep, slow, knotted. I said: Qi and Blood both deficient. Used Dang Gui 2 liang, Fu Zi 3 qian. One dose reduced pain by half; two doses cured, no recurrence. Correct prescription matches effect instantly. (Note: Da Huan records Qi-deficient headache treated with large dose Bu Zhong Yi Qi Tang plus Shu Fu Zi, refer.)
A woman with chronic lateral headache cured by Da Cheng Qi Tang. Why? Yangming Dry-Metal overacts, suppressing Liver Qi stagnation; stagnation causes Blood obstruction; obstruction blocks upper/lower flow, causing dryness/constraint. Cheng Qi Tang unblocks, Qi-Blood circulates, Liver Qi opens. Shang Han Zhi Li states: Shaoyang lateral headache often with constipation, suitable for purging. This is for new illness; for chronic illness with insufficient Yuan Qi, treat differently (Xu Yi Shuo).
Treatment Requires Clearing Fire and Cooling Blood:
Chronic headache, triggered by slight wind-cold, requiring heavy cotton/warm wraps in winter, belongs to Depressed Heat, Root Heat with Branch Cold.