大全云∶夫头者，诸阳之会也。凡产后五
脏皆虚，胃气亏弱，饮食不充，谷气尚乏，则令虚热，阳气不守，上凑于头，阳实阴虚，则令头
痛也。又有产后败血头痛，不可不知，黑龙丹言之甚详。
薛氏曰∶前证若中气虚，用补中益气汤加蔓荆子。若血虚，用四物加参术。血气俱虚，
用八珍汤。若因风寒所伤，用补中益气汤加川芎，（以风寒所伤，而用补中益气，尚须斟酌）
一产妇患头痛，日用补中益气汤不缺，已三年矣，稍劳则恶寒内热，为阳气虚，以前汤
加附子一钱，数剂不发。
一妇人产后头痛面青二年矣，日服四物等药。余谓肾水不能生肝木而血虚，用六味丸
加五味子，两月而瘥。
郭茂恂嫂金华君产七日，不食，始言头痛，头痛已又心痛作，既而目睛痛，如割如刺，
更作更止，相去无瞬息间，每头痛甚，欲取大石压，良久渐定，心痛作则以十指抓臂，血流
满掌，痛定目复痛，又以两手自剜取之，如是十日不已，众医无计。进黑龙丹半粒（黑龙丹
见胞衣不下条），疾少间，中夜再服，乃瞑目寝如平时，至清晨下一行，约三升许，如蝗虫子，
三疾减半，巳刻又行如前，则顿愈矣。（此虫咬痛也，不如用杀虫药更神效）
一奇散（即芎归汤） 治产后血虚头痛。
当归 川芎（各二钱半）
上为细末，每服二钱，水一盏煎七分，温服。
芎乌散 治产后气滞头痛。
天台乌药 大川芎（各等分）
上为细末，每服三钱，烧红秤锤，淬酒调服。（服法佳）
芎附散 治产后气虚头痛及败血作梗头痛，诸药不效者。
川芎（一两） 大附子（一个。去皮脐，切四片，拌酽醋一碗，炙附子，蘸醋尽为度）
上为末，每服二钱，清茶调服。
加减四物汤 治产后头痛血虚，痰癖寒
厥，皆令头痛。（产后头痛，至于血虚，正治也，求之瘀血，实法也，似瘀血而非瘀血，反下如
蝗虫子者，怪也，若痰癖寒厥气虚，则又寻之杂症矣。经曰∶有者求之，无者求之，岂可执一
哉。知常知变，斯为上工矣）
苍术（一两六钱） 羌活 川芎 防风 香附（炒） 白芷（各一两） 石膏（二两半） 细辛（一两半）
当归 甘草（各五钱）
上锉，每服一两，水煎，服无时。如有汗者，知气虚头痛也，加芍药三两，桂一两半，生
姜煎。如热痰头痛，加白芷三两，石膏三两，知母一两。如寒厥头痛，加天麻三两，附子一两
半，生姜三片，煎服。
《大全》说：头，是诸阳经汇聚的地方。凡是产后五脏都虚弱，胃气亏损衰弱，饮食摄入不足，水谷精气尚且匮乏，就会引发虚热，阳气不能固守，向上冲聚于头部，导致阳实阴虚，从而引起头痛。又有产后败血（瘀血）引起的头痛，不可不知道，黑龙丹对此论述得非常详细。
薛氏说：上述病症如果属于中气虚弱，使用补中益气汤加蔓荆子。如果是血虚，使用四物汤加人参、白术。如果气血俱虚，使用八珍汤。如果是因风寒邪气所伤，使用补中益气汤加川芎。（因为被风寒所伤而用补中益气汤，还需要斟酌考量）。有一位产妇患头痛，每天服用补中益气汤不间断，已经三年了，稍微劳累就出现怕冷和内部发热，这是阳气虚弱，用前面的方剂加一钱附子，服了几剂后不再发作。
另一位妇人产后头痛且面色发青已有两年，每天服用四物汤等药物。我认为这是肾水不能滋养肝木而导致血虚，使用六味丸加五味子，两个月后痊愈。
郭茂恂的嫂子金华君生产七天后，不吃东西，才开始诉说头痛，头痛之后又心痛发作，接着眼睛疼痛，像切割一样，像针刺一样，疼痛反复发作，没有片刻停歇，每次头痛剧烈时，想要找大石头压住头部，过了很久才逐渐平静；心痛发作时就用手十指抓挠手臂，血流满手掌；痛定之后眼睛又痛，就用双手自己挖取眼球，这样持续十天不止，众医生没有办法。进服半粒黑龙丹（黑龙丹见胞衣不下条），病情稍缓解，半夜再服一次，于是闭上眼睛像平时一样入睡，到清晨排下一行粪便，大约三升左右，形状像蝗虫卵，三种疾病减轻了一半，巳刻（上午9-11点）又排出与前次相同的粪便，于是顿时痊愈了。（这是虫咬造成的疼痛，不如用杀虫药更神效）。
一奇散（即芎归汤）治疗产后血虚头痛。
当归、川芎（各二钱半）
以上研为细末，每次服用二钱，用水一盏煎至七分，温服。
芎乌散治疗产后气滞头痛。
天台乌药、大川芎（各等分）
以上研为细末，每次服用三钱，将秤锤烧红，投入酒中淬取药汁调服。（这种服法很好）。
芎附散治疗产后气虚头痛及败血阻滞引起的头痛，其他药物无效者。
川芎（一两）、大附子（一个。去皮和脐，切成四片，与一碗浓醋拌合，炙烤附子，蘸醋直到醋吸尽为止）
以上研为末，每次服用二钱，用清茶调服。
加减四物汤治疗产后头痛血虚，痰癖寒厥，都会导致头痛。（产后头痛，至于血虚，是正治法；寻求瘀血，是实证治法；看似瘀血而非瘀血，反而排出像蝗虫卵一样的东西，很奇怪；如果是痰癖、寒厥、气虚，则是寻找杂症了。经文说：有的病证要探求其成因，无的病证也要探求其机理，怎么能固执一端呢？懂得常规又懂得变通，这才是上等的医生啊）。
苍术（一两六钱）、羌活、川芎、防风、香附（炒）、白芷（各一两）、石膏（二两半）、细辛（一两半）、当归、甘草（各五钱）
以上切碎，每次服用一两，用水煎煮，服药时间不拘。如果有汗出的，说明是气虚头痛，加芍药三两，桂枝一两半，生姜煎服。如果是热痰头痛，加白芷三两，石膏三两，知母一两。如果是寒厥头痛，加天麻三两，附子一两半，生姜三片，煎服。
The *Daquan* states: The head is the convergence point of all Yang meridians. After childbirth, the five zang organs are all deficient, stomach qi is depleted and weak, dietary intake is insufficient, and grain qi remains scarce. This leads to deficiency heat, where yang qi fails to remain anchored and rushes upward to the head. The resulting excess of yang and deficiency of yin causes headache. There is also headache caused by postpartum retained blood (stasis), which must not be overlooked; the *Heilong Dan* discusses this in detail.
Xue states: If the aforementioned symptoms are due to middle qi deficiency, use *Buzhong Yiqi Tang* (Tonify the Middle and Augment the Qi Decoction) with added *Manjingzi* (Vitex Fruit). If it is blood deficiency, use *Siwu Tang* (Four Substance Decoction) with added *Renshen* (Ginseng Root) and *Baizhu* (Atractylodes Rhizome). If both qi and blood are deficient, use *Bazhen Tang* (Eight Treasure Decoction). If caused by injury from wind-cold pathogens, use *Buzhong Yiqi Tang* with added *Chuanxiong* (Szechwan Lovage Rhizome). (Using *Buzhong Yiqi Tang* for wind-cold injury requires careful consideration.) One parturient suffered from headache, taking *Buzhong Yiqi Tang* daily without interruption for three years. Slight exertion triggered aversion to cold and internal heat, indicating yang qi deficiency. Adding one qian of *Fuzi* (Prepared Aconite Lateral Root) to the previous decoction stopped the attacks after a few doses.
Another woman had suffered from headache and a bluish complexion for two years postpartum, taking *Siwu Tang* and other medicines daily. I reasoned that kidney water failed to nourish liver wood, leading to blood deficiency. Using *Liuwei Wan* (Six-Ingredient Pill with Rehmannia) with added *Wuweizi* (Schisandra Berry), she recovered within two months.
Jinhua Jun, sister-in-law of Guo Maoxun, did not eat for seven days after childbirth, then began complaining of headache. Following the headache, heart pain occurred, followed by eye pain, described as cutting or stabbing. The pain came and went continuously without a moment's respite. When the headache was severe, she desired a large stone to press upon her head; only after a long time did it gradually subside. When heart pain occurred, she scratched her arms with ten fingers until blood filled her palms. Once the pain subsided, eye pain returned, and she dug at her eyes with her hands. This persisted for ten days, and no physicians knew what to do. Administering half a pill of *Heilong Dan* (see section on Retained Placenta) slightly alleviated the disease. She took another dose at midnight, then closed her eyes and slept as usual. By early morning, she passed a stool of about three sheng, resembling locust eggs. The three ailments were reduced by half. At the Si hour (9–11 AM), she passed stool again as before, and was suddenly cured. (This pain was caused by insect bites; using vermifuges would have been more effective.)
*Yiqi San* (One Extraordinary Powder), also known as *Xionggui Tang*, treats postpartum headache due to blood deficiency.
*Danggui* (Angelica Sinensis Root) and *Chuanxiong* (Szechwan Lovage Rhizome) (each 2.5 qian).
Grind into fine powder. Take 2 qian per dose, decoct with one cup of water until reduced to 0.7 cup, and take warm.
*Xiong Wu San* treats postpartum headache due to qi stagnation.
*Tiantai Youyao* (Tiantai Betel Nut with Coptis Rhizome) and *Dachuanxiong* (Large Szechwan Lovage Rhizome) (equal parts).
Grind into fine powder. Take 3 qian per dose. Red-hot a steelyard weight should be quenched in wine to extract the essence, then mixed with the powder for administration. (This method of administration is excellent.)
*Xiong Fu San* treats postpartum headache due to qi deficiency and headache caused by retained blood obstruction, when other medicines fail.
*Chuanxiong* (Szechwan Lovage Rhizome) (1 liang), *Da Fuzi* (Large Prepared Aconite Lateral Root) (one piece. Peel off skin and navel, cut into four slices, mix with one bowl of strong vinegar, roast the *Fuzi*, dipping it in vinegar until the vinegar is fully absorbed).
Grind into powder. Take 2 qian per dose, mixed with clear tea.
*Jiajian Siwu Tang* (Modified Four Substance Decoction) treats postpartum headache due to blood deficiency, phlegm-stagnation, cold-jue, all of which can cause headache. (For postpartum headache, addressing blood deficiency is the standard treatment; seeking stasis is the treatment for excess patterns. If it appears like stasis but is not, and instead material resembling locust eggs is expelled, this is unusual. If it involves phlegm-stagnation, cold-jue, or qi deficiency, one must investigate miscellaneous diseases. The Classics state: "Seek the cause where there is [pathology], seek the mechanism where there is none." How can one adhere rigidly to one approach? Knowing the constant and knowing the variable makes one an superior physician.)
*Cangzhu* (Atractylodes Rhizome) (1 liang 6 qian), *Qianghuo* (Notopterygium Rhizome), *Chuanxiong* (Szechwan Lovage Rhizome), *Fangfeng* (Saposhnikovia Root), *Xiangfu* (Cyperus Rhizome, stir-fried), *Baizhi* (Angelica Dahurica Root) (each 1 liang), *Shigao* (Gypsum Fibrosum) (2.5 liang), *Xixin* (Asarum Root) (1.5 liang), *Danggui* (Angelica Sinensis Root), *Gancao* (Licorice Root) (each 5 qian).
Cut into pieces. Take 1 liang per dose, decoct in water, and take at any time. If sweating occurs, it indicates qi-deficiency headache; add *Shaoyao* (Peony Root) 3 liang, *Guizhi* (Cinnamon Twig) 1.5 liang, and decoct with *Shengjiang* (Fresh Ginger Rhizome). If it is headache due to hot-phlegm, add *Baizhi* (Angelica Dahurica Root) 3 liang, *Shigao* (Gypsum Fibrosum) 3 liang, and *Zhimu* (Anemarrhena Rhizome) 1 liang. If it is headache due to cold-jue, add *Tianma* (Gastrodia Rhizome) 3 liang, *Fuzi* (Prepared Aconite Lateral Root) 1.5 liang, and *Shengjiang* (Fresh Ginger Rhizome) 3 slices, and decoct for administration.