秦子曰∶头痛头风，同一症也。头风者，头痛症中之症，方书以痛之久者为头风，暴起
者为头痛。其词盖以头痛为外感，头风为内伤。愚意虽有新久之别，而外感内伤之分，不在
此也。头痛头风，同归于痛而已，因于风者，名头风可也。伤寒门头痛，皆是三阳经表症，
今在杂症门，虽分外感内伤，然三阳三阴，皆有头痛。
【头痛之症】初起不因内伤，忽尔头额作痛，沿门多病，大小传染，此外感岁运之气
，所谓天行症也。若起居不谨，睡卧当风，冲寒冒雪，不因传染而病头痛，此外感六淫之邪，所
谓人自感冒症也。若恶寒发热，头项巅脑发际作痛，太阳症也。咳哕烦心痞满，额前作痛，
阳明症也。时寒时热，鬓边作痛，少阳症也。心疼烦闷头痛，痛连 骨，少阴症也。干呕吐
涎沫，痛在巅顶，厥阴症也。若头旋发热，有汗者，风痛也。恶寒发热，无汗者，寒痛也。
夏令头痛，发热汗多口渴者，暑痛也。头重而痛，天阴则发，湿痛也。口干唇裂，烦躁便闭
，燥痛也。暴厥昏倒，烦热不卧，火邪痛也。
【头痛之因】少阳之政，风胜乃摇，候乃大温，病头痛。又云阳明之复，咳哕烦心，
病在膈中，头乃痛。太阳之胜，热反上行，头项脑户中痛。太阳之复，心痛痞满，头痛。太阴之
政，腰脊头顶痛。又云太阴在泉，湿淫所胜，病冲头痛，目似脱，项似拔，此皆岁运之加临
，人在气交中，潜受其气，搏于经络之中，则成天行头痛之症矣。若不因天行司政之气，自
觉起居不慎，坐卧当风，风寒暑湿，入于经络，则成自感六淫之头痛也。
【头痛之脉】脉必浮大。浮缓伤风；浮紧伤寒。虚数者暑；洪数者热。寸大易愈；尺
【头痛之治】宜详天行、自感，属何经所主。若在太阳经者，选奇方。在阳明经，清
震汤
涎沫者，吴茱萸汤主之。因于风者，加风药；因于寒者，加热药；因于暑湿者，加凉燥之药
；因于燥热者，加清润之药。运气加临，须详运气用药。又少阳头痛，耳前后脉涌有热，刺
出其血，故余家秘治头痛，不按经穴，随其所痛之处而刺之，则不必出血而痛即减。此宗《
选奇方
防风 羌活 黄芩 甘草
因于风，倍加荆芥、防风；有寒，去黄芩，加川芎、细辛；有暑，加石膏、香薷；有湿
，加苍术、白芷；有燥，加知母、石膏；有火，加黄连、山栀。
清震汤
升麻 苍术 干葛 甘草 鲜荷叶
有风，加防风、荆芥；有寒，加川芎、细辛；有暑，加黄连、石膏；有湿，加白芷；有
燥，加知母、石膏；火旺，加山栀、黄连。
石膏散
石膏 川芎 白芷 葛根
为细末。
清空膏
柴胡 黄芩 黄连 甘草 川芎 羌活 防风
有风，加荆芥，倍防风；有寒，去黄芩、黄连，加生姜、细辛；有暑，加石膏、黄连；
有湿，加苍术、白芷；有燥，加知母、石膏；火旺，加山栀、黄连。
独活细辛汤
独活 细辛 川芎 秦艽 生地 羌活 防风 甘草
有风，加荆芥，倍防风；有寒，加麻黄、桂枝；有暑，加黄芩、石膏；有湿，加苍术
、白芷；有燥，加石膏、竹叶；火旺，加知母、黄柏。
苍术除湿汤
苍术 白术 浓朴 白茯苓 陈皮 甘草 半夏曲
有风，加防风；有寒，加生姜；有暑，加黄芩；有湿，加川芎、白芷；有燥，加知母、
吴茱萸汤
吴茱萸 人参 大枣 生姜
秦子说：头痛和头风，是同一种病症。所谓头风，是头痛病症中的一种；医书将疼痛持续时间长的称为头风，突然发作的称为头痛。这种说法大概是将头痛归为外感病，头风归为内伤病。我认为虽然有新发和陈旧的区别，但外感与内伤的区分并不在此。头痛和头风，归根结底都是疼痛罢了，如果是因风邪引起的，可以称之为头风。《伤寒论》门中的头痛，都是三阳经（太阳、阳明、少阳）的表证；现在在杂症门中，虽然区分了外感和内伤，但实际上三阳经和三阴经（太阴、少阴、厥阴）都有可能出现头痛。
【头痛的症状】起初不是因为内伤，而是忽然出现前额及头部疼痛，周围很多人患病，大小人之间互相传染，这是感受了当年岁运的气候之气，也就是所谓的“天行”病症（流行性传染病）。如果起居不慎，睡觉时对着风口，受寒冒雪，不是通过传染而是自身感邪而患头痛，这是感受六淫（风、寒、暑、湿、燥、火）邪气，也就是所谓的“自感冒”病症。如果出现恶寒发热，头项部、头顶及发际处疼痛，属于太阳病（足太阳膀胱经受邪）。如果出现咳嗽、呃逆、心烦、胸脘痞闷，前额疼痛，属于阳明病（足阳明胃经受邪）。如果出现忽冷忽热，鬓角处疼痛，属于少阳病（足少阳胆经受邪）。如果出现心痛、烦闷、头痛，疼痛牵连到骨节深处，属于少阴病（足少阴肾经受邪）。如果出现干呕、吐出清稀涎沫，疼痛位于头顶，属于厥阴病（足厥阴肝经受邪）。如果头晕发热，有汗出的，是风痛。如果恶寒发热，无汗出的，是寒痛。夏季发生的头痛，伴有发热、多汗、口渴的，是暑痛。头部沉重且疼痛，阴天发作的，是湿痛。口干唇裂，烦躁、大便闭结的，是燥痛。突然昏厥倒地，烦热不能安卧的，是火邪痛。
【头痛的原因】少阳主令之时，风气偏胜则导致摇动，气候变得大温，易发生头痛。又说，当阳明之气复返时，会出现咳嗽、呃逆、心烦，病位在膈中，头部就会疼痛。当太阳之气偏胜时，热气反而上行，导致头项、脑户部位疼痛。当太阳之气复返时，会出现心痛、痞闷、头痛。当太阴主令时，会出现腰脊、头顶疼痛。又说，当太阴在泉时，湿气过盛，会导致冲逆性头痛，眼睛感觉像要脱出，颈部感觉像被拉扯一样，这些都是岁运加临的影响，人在天地气交之中，暗中受到这些气候之气的侵袭，搏结于经络之中，就形成了天行头痛的病症。如果不是因为天行司政之气的变化，而是自觉起居不慎，坐卧当风，风寒暑湿侵入经络，就形成了自身感受六淫邪气的头痛。
【头痛的脉象】脉象必定浮大。脉浮缓表示伤风；脉浮紧表示伤寒。脉虚数表示中暑；脉洪数表示受热。寸口脉大者容易治愈；尺脉……（原文此处中断）
【头痛的治疗】应当详细辨别是天行流行还是自身感受，属于哪一经所主。如果在太阳经，选用选奇方。在阳明经，选用清震汤。若呕吐涎沫者，以吴茱萸汤为主治。因风邪引起的，加入祛风药；因寒邪引起的，加入温热药；因暑湿引起的，加入清凉燥湿的药；因燥热引起的，加入清热滋润的药。运气加临时，必须根据运气理论来用药。另外，少阳头痛，耳前后脉搏涌动且有热感，应刺出其血，所以我家秘传的治头痛方法，不按常规经络穴位，而是随着疼痛的部位进行针刺，这样就不必放血而疼痛即可减轻。这宗法于《选奇方》。
选奇方组成：防风、羌活、黄芩、甘草。
因风邪重，加倍荆芥、防风；有寒邪，去掉黄芩，加入川芎、细辛；有暑邪，加入石膏、香薷；有湿邪，加入苍术、白芷；有燥邪，加入知母、石膏；有火邪，加入黄连、山栀。
清震汤组成：升麻、苍术、干葛、甘草、鲜荷叶。
有风邪，加入防风、荆芥；有寒邪，加入川芎、细辛；有暑邪，加入黄连、石膏；有湿邪，加入白芷；有燥邪，加入知母、石膏；火旺，加入山栀、黄连。
清空膏组成：柴胡、黄芩、黄连、甘草、川芎、羌活、防风。
有风邪，加入荆芥，倍用防风；有寒邪，去掉黄芩、黄连，加入生姜、细辛；有暑邪，加入石膏、黄连；有湿邪，加入苍术、白芷；有燥邪，加入知母、石膏；火旺，加入山栀、黄连。
独活细辛汤组成：独活、细辛、川芎、秦艽、生地、羌活、防风、甘草。
有风邪，加入荆芥，倍用防风；有寒邪，加入麻黄、桂枝；有暑邪，加入黄芩、石膏；有湿邪，加入苍术、白芷；有燥邪，加入石膏、竹叶；火旺，加入知母、黄柏。
苍术除湿汤组成：苍术、白术、浓朴、白茯苓、陈皮、甘草、半夏曲。
有风邪，加入防风；有寒邪，加入生姜；有暑邪，加入黄芩；有湿邪，加入川芎、白芷；有燥邪，加入知母、
Qin Zi said: Headache and Toufeng (chronic headache/head wind) are the same syndrome. Toufeng is a specific type within headache syndromes; medical texts define chronic, long-lasting pain as Toufeng, while sudden onset pain is defined as headache. This terminology seems to attribute headache to external contraction and Toufeng to internal injury. I believe that although there is a distinction between new and old onset, the differentiation between external contraction and internal injury does not lie here. Both headache and Toufeng ultimately result in pain; if caused by Wind pathogen, it may be named Toufeng. The headaches described in the *Shanghan* (Cold Damage) section are all exterior syndromes of the Three Yang meridians (Taiyang, Yangming, Shaoyang). Now, in the miscellaneous diseases section, although external contraction and internal injury are distinguished, headaches can occur in both the Three Yang and Three Yin meridians (Taiyin, Shaoyin, Jueyin).
[Symptoms of Headache] Initially, without prior internal injury, sudden pain occurs in the forehead and head. Many people in the vicinity fall ill, spreading among adults and children alike. This is due to contracting the climate qi of the annual cycle, known as "Tianxing" syndrome (epidemic disease). If one is careless in daily life, sleeps facing drafts, or suffers from cold and snow exposure, contracting illness without contagion, this is due to the Six Excesses (Wind, Cold, Summerheat, Dampness, Dryness, Fire) pathogenic factors, known as "self-contracted cold" syndrome. If accompanied by aversion to cold and fever, with pain in the nape, vertex, and hairline, it is a Taiyang syndrome. If accompanied by coughing, hiccups, vexation, chest fullness, and frontal headache, it is a Yangming syndrome. If accompanied by alternating chills and fever, with pain at the temples, it is a Shaoyang syndrome. If accompanied by heart pain, vexation, headache radiating to the bones, it is a Shaoyin syndrome. If accompanied by dry retching, vomiting of clear saliva, and vertex headache, it is a Jueyin syndrome. If accompanied by dizziness, fever, and sweating, it is Wind-pain. If accompanied by aversion to cold, fever, and absence of sweat, it is Cold-pain. Headaches occurring in summer with fever, profuse sweating, and thirst are Summerheat-pain. Heavy and painful head, worsening on cloudy days, is Damp-pain. Dry mouth, cracked lips, vexation, and constipation indicate Dryness-pain. Sudden syncope, restlessness, inability to lie down, and heat sensation indicate Fire-pathogen pain.
[Etiology of Headache] When Shaoyang governs, excessive Wind causes tremors, and the climate becomes excessively warm, leading to headache. It is also stated that when Yangming Qi rebounds, coughing, hiccups, and vexation occur, with pathology in the diaphragm, causing headache. When Taiyang Qi prevails, heat rises upward, causing pain in the head, nape, and occiput. When Taiyang Qi rebounds, heart pain, fullness, and headache occur. When Taiyin governs, pain occurs in the lower back, spine, and vertex. It is also stated that when Taiyin is in the Earthly Branch position, excessive Dampness causes rushing headache, eyes feeling as if they will protrude, and neck feeling as if being pulled. These are all effects of the annual cycle superimposed upon the environment. Humans, existing within the intersection of Heaven and Earth Qi, secretly absorb these climatic influences, which stagnate in the meridians, forming Tianxing headache. If not caused by the governing Qi of the annual cycle, but rather due to careless living, sitting or lying in drafts, where Wind, Cold, Summerheat, and Dampness invade the meridians, self-contracted Six Excesses headache results.
[Pulse Diagnosis of Headache] The pulse must be Floating and Large. Floating and Wiry indicates Wind-injury; Floating and Tight indicates Cold-injury. Deficient and Rapid indicates Summerheat; Full and Rapid indicates Heat. A Large Cun (inch) position suggests easier recovery; the Chi (cubit) position... [text cuts off].
[Treatment of Headache] One must carefully distinguish whether it is epidemic or self-contracted, and which meridian is primarily affected. If in the Taiyang meridian, select Xuanqi Decoction. If in the Yangming meridian, select Qingzhen Decoction. For those vomiting saliva, Wuzhuyu Tang is the primary treatment. If caused by Wind, add Wind-expelling herbs; if by Cold, add Warmth-providing herbs; if by Summerheat-Dampness, add Cooling and Drying herbs; if by Dryness-Heat, add Clearing and Moistening herbs. When dealing with climatic cycles, medication must follow the principles of these cycles. Furthermore, for Shaoyang headache, where pulses around the ears surge with heat, bloodletting should be performed. Therefore, my family's secret method for treating headache does not strictly follow meridian points but needles directly at the site of pain, reducing pain without necessarily bleeding. This follows the principle of *Xuanqi Fang*.
**Xuanqi Decoction**: Fangfeng (Saposhnikoviae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma).
For severe Wind, double Jingjie and Fangfeng; for Cold, remove Huangqin, add Chuanxiong and Xixin; for Summerheat, add Shigao and Xiangru; for Dampness, add Cangzhu and Baizhi; for Dryness, add Zhimu and Shigao; for Fire, add Huanglian and Zhizi.
**Qingzhen Decoction**: Shengma (Cimicifugae Rhizoma), Cangzhu (Atractylodis Rhizoma), Genge (Puerariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Xianheyeye (Nelumbinis Folium).
For Wind, add Fangfeng and Jingjie; for Cold, add Chuanxiong and Xixin; for Summerheat, add Huanglian and Shigao; for Dampness, add Baizhi; for Dryness, add Zhimu and Shigao; for excess Fire, add Zhizi and Huanglian.
**Shigao San**: Shigao (Gypsum Fibrosum), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baizhi (Angelicae Dahuricae Radix), Gegen (Puerariae Radix).
Grind into fine powder.
**Qingkong Gao**: Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma), Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix).
For Wind, add Jingjie, double Fangfeng; for Cold, remove Huangqin and Huanglian, add Shengjiang and Xixin; for Summerheat, add Shigao and Huanglian; for Dampness, add Cangzhu and Baizhi; for Dryness, add Zhimu and Shigao; for excess Fire, add Zhizi and Huanglian.
**Duhuo Xixin Tang**: Duhuo (Angelicae Pubescentis Radix), Xixin (Asari Radix et Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma), Qinjiao (Gentianae Macrophyllae Radix), Shengdi (Rehmanniae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Gancao (Glycyrrhizae Radix et Rhizoma).
For Wind, add Jingjie, double Fangfeng; for Cold, add Mahuang and Guizhi; for Summerheat, add Huangqin and Shigao; for Dampness, add Cangzhu and Baizhi; for Dryness, add Shigao and Zhuye; for excess Fire, add Zhimu and Huangbai.
**Cangzhu Chushi Tang**: Cangzhu (Atractylodis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Houpo (Magnoliae Officinalis Cortex), Fuling (Poria), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma), Banxiaqu (Pinelliae Fermentatum).
For Wind, add Fangfeng; for Cold, add Shengjiang; for Summerheat, add Huangqin; for Dampness, add Chuanxiong and Baizhi; for Dryness, add Zhimu and
**Wuzhuyu Tang**: Wuzhuyu (Evodiae Fructus), Renshen (Ginseng Radix et Rhizoma), Dazao (Zizyphi Fructus), Shengjiang (Zingiberis Rhizoma Recens).