(《灵枢·厥病篇》)
厥头痛,面若肿起而烦心,取之足阳明、太阴。(厥,逆也。邪逆于经,上干头脑而为痛者,曰厥头痛也。下仿此。
足阳明之脉上行于面,其悍气上冲头者,循眼系入络脑,足太阴支者注心中,故以头痛而兼面肿烦心者,当取足之阳明、
太阴也。)厥头痛,头脉痛,心悲善泣,视头动脉反盛者,刺尽去血,后调足厥阴。(头脉痛者,痛在皮肉血脉之间也。
心悲善泣者,气逆在肝也。故当先视头脉之动而盛者,刺去其血以泄其邪,然后取足厥阴肝经而调补之,以肝脉会于巅
也。)厥头痛,贞贞头重而痛,泻头上五行、行五,先取手少阴,后取足少阴。(贞贞,坚固貌,其痛不移也。头上五行、
行五,即前篇热病五十九俞之穴,所以散诸阳之热逆也。先取手少阴心经,泻南方以去火也。后取足少阴肾经,补北方
以壮水也。)厥头痛,意善忘,按之不得,取头面左右动脉,后取足太阴。(脾藏意,意伤则善忘。阳邪在头而无定所,
则按之不得。故当先取头面左右动脉以泄其邪,后取足太阴经以补脾气也。)厥头痛,项先痛,腰脊为应,先取天柱,后
取足太阳。(项先痛,腰脊为应,皆足太阳经也。故当先取天柱,后及本经之下 。)厥头痛,头痛甚,耳前后脉涌有热,
泻出其血,后取足少阳。(耳之前后,足少阳经也。其脉涌而热者,当泻出热血,仍取本经之穴。有热,一本云有动脉。)
真头痛,头痛甚,脑尽痛,手足寒至节,死不治。(头痛有二∶上文言厥头痛者可治,此言真头痛者不可治。盖头为诸阳
之会,四肢为诸阳之本,若头痛甚而遍尽于脑、手足寒至节者,以元阳败竭,阴邪直中髓海,故最为凶兆。)头痛不可取
于者,有所击堕,恶血在于内,若肉伤痛未已,可则刺,不可远取也。(头痛因于击堕者,多以恶血在脉络之内,故伤
痛未已,若可刺者,但当刺去其痛处之血,不可远取荥 ,徒伤正气,盖此非大经之病也。)头痛不可刺者,大痹为恶,
日作者,可令少愈,不可已。(痹之甚者,谓之大痹。其证则风寒湿三气杂至,合成恶患,令人头痛,不可刺也。若日作
者,则犹有间止,故刺之可令少愈,终亦不能全已也。)头半寒痛,先取手少阳、阳明,后取足少阳、阳明。(头半寒痛
者,偏头冷痛也。手足少阳阳明之脉,皆循耳上行头角,故当先取手经以去其标,后取足经以去其本也。)
(出自《灵枢·厥病篇》)
厥头痛,面部浮肿且心烦意乱,应取足阳明经和足太阴经的穴位。(注:厥,意为逆。邪气逆乱于经脉,上扰头脑导致疼痛的,称为厥头痛。以下类推。)足阳明经脉上行至面部,其剽悍之气冲向上头,沿眼系入络于脑;足太阴经的分支注入心中,因此对于头痛兼有面肿、心烦的症状,应当取足阳明、足太阴经的穴位。)
厥头痛,头部血脉搏动性疼痛,情绪悲伤容易哭泣,观察头部动脉异常充盛的地方,针刺放血直至邪气尽去,之后调理足厥阴经。(注:头脉痛,指疼痛位于皮肉血脉之间。心悲善泣,是气逆在肝的表现。因此应当先观察头部跳动充盛的动脉,针刺放血以泄除邪气,然后取足厥阴肝经进行调补,因为肝经会合于头顶。)
厥头痛,头部沉重且疼痛持续不移,泻头上五行、每行五穴,先取手少阴经,后取足少阴经。(注:贞贞,形容坚固的样子,指疼痛位置固定不移。头上五行、每行五穴,即前篇热病五十九俞的穴位,用于疏散诸阳之热逆。先取手少阴心经,以泻南方之火去火邪;后取足少阴肾经,以补北方之水壮水制火。)
厥头痛,意念容易遗忘,按压头部找不到痛点,取头面左右的动脉,后取足太阴经。(注:脾藏意,意受伤则容易遗忘。阳邪在头部而无固定位置,所以按压找不到痛点。因此应当先取头面左右动脉以泄除邪气,后取足太阴经以补脾气。)
厥头痛,颈部先痛,腰脊随之感应疼痛,先取天柱穴,后取足太阳经。(注:颈先痛,腰脊相应而痛,都属于足太阳经。因此应当先取天柱穴,再取本经下方的穴位。)
厥头痛,头痛剧烈,耳前后脉搏涌动且有热象,泻出热血,后取足少阳经。(注:耳之前后,是足少阳经循行部位。其脉涌动而有热,应当泻出热血,仍取本经穴位。有的版本作“有动脉”。)
真头痛,头痛剧烈,脑部全部疼痛,手足寒冷直到关节,属于死证,无法治疗。(注:头痛分为两种:上文说的厥头痛是可以治疗的,这里说的真头痛是无法治疗的。因为头为诸阳之会,四肢为诸阳之本,如果头痛剧烈且遍及全脑、手足寒冷至关节,是因为元阳败竭,阴邪直中髓海,所以是最凶险的征兆。)
因击打或坠落导致的头痛不可随意远取穴位,体内有瘀血,如果肌肉伤痛尚未停止,可以就近针刺,不可远取荥穴。(注:头痛因于击打坠落的,多因瘀血在脉络之内,所以伤痛未止。如果可以针刺,只应当刺去痛处的瘀血,不可远取荥穴,以免徒伤正气,因为这并非大经的病证。)
不可针刺的头痛,是大痹症引起的恶疾,每天发作的,针刺可使其稍有好转,但不能痊愈。(注:痹症严重的称为大痹。其证候是风寒湿三气杂至,合成恶患,令人头痛,不可轻易针刺。如果每天发作,说明还有间歇期,所以针刺可使其稍有好转,但最终也不能完全治愈。)
头半侧冷痛,先取手少阳经、手阳明经,后取足少阳经、足阳明经。(注:头半侧冷痛,即偏头冷痛。手足少阳、阳明经脉都循行耳朵上行至头角,因此应当先取手经以去除标症,后取足经以去除本症。)
(From "Ling Shu: Jue Bing Pian")
Jue Tou Tong (Headache due to Counterflow Qi), characterized by facial swelling and mental restlessness, should be treated by selecting points on the Foot-Yangming and Foot-Taiyin meridians. (Note: "Jue" means counterflow or rebellion. When pathogenic factors rebel within the meridians and ascend to disturb the head causing pain, it is called Jue Tou Tong. The following cases follow this pattern.) The Foot-Yangming meridian ascends to the face; its vigorous Qi rushes upward to the head, following the eye system to connect with the brain. The branch of the Foot-Taiyin meridian enters the heart. Therefore, for headaches accompanied by facial swelling and mental restlessness, points on the Foot-Yangming and Foot-Taiyin meridians should be selected.
Jue Tou Tong (Headache due to Counterflow Qi), characterized by throbbing pain in the head vessels, sadness, and a tendency to weep, requires observing where the head arteries are abnormally full. Puncture these areas to release blood until the pathogen is exhausted, then regulate the Foot-Jueyin meridian. (Note: Throbbing pain in head vessels indicates pain located between the skin, flesh, and blood vessels. Sadness and weeping indicate Qi rebellion in the Liver. Thus, one should first observe the pulsating, full arteries on the head, puncture them to release blood and drain the pathogen, then select the Foot-Jueyin Liver meridian for regulation, as the Liver meridian converges at the vertex.)
Jue Tou Tong (Headheadache due to Counterflow Qi), characterized by a heavy, persistent, and fixed headache, requires draining five rows of five acupoints on the head. First, select the Hand-Shaoyin meridian, then the Foot-Shaoyin meridian. (Note: "Zhenzhen" describes a firm, unchanging state, indicating fixed pain. The five rows of five acupoints on the head refer to the 59 Acupoints for Heat Diseases mentioned in previous chapters, used to dissipate rebellious heat from all Yang meridians. First, select the Hand-Shaoyin Heart meridian to drain Fire in the South; then, select the Foot-Shaoyin Kidney meridian to tonify Water in the North to strengthen Yin.)
Jue Tou Tong (Headache due to Counterflow Qi), characterized by forgetfulness and inability to locate tenderness upon palpation, requires selecting the arteries on the left and right sides of the head and face, followed by the Foot-Taiyin meridian. (Note: The Spleen houses Yi (Intellect); injury to Yi leads to forgetfulness. Yang pathogens in the head without a fixed location result in non-localizable tenderness. Thus, one should first select the arteries on the head and face to drain the pathogen, then select the Foot-Taiyin Spleen meridian to tonify Spleen Qi.)
Jue Tou Tong (Headache due to Counterflow Qi), starting with neck pain that corresponds to soreness in the lower back and spine, requires first selecting Tianzhu (BL10), then the Foot-Taiyang meridian. (Note: Neck pain corresponding to lower back and spine pain belongs to the Foot-Taiyang meridian. Thus, one should first select Tianzhu, then points lower down on the same meridian.)
Jue Tou Tong (Headache due to Counterflow Qi), characterized by severe headache, surging pulses around the ears with heat sensations, requires releasing hot blood, followed by the Foot-Shaoyang meridian. (Note: The area before and behind the ear is traversed by the Foot-Shaoyang meridian. Where the pulse surges with heat, hot blood should be released, and points on this meridian should still be selected. Some versions read "presence of arterial pulsation".)
Zhen Tou Tong (True Headache), characterized by severe headache, pain throughout the entire brain, and cold hands and feet extending to the joints, is a fatal condition that cannot be treated. (Note: There are two types of headache: the aforementioned Jue Tou Tong is treatable, whereas Zhen Tou Tong is untreatable. The head is the convergence of all Yang meridians, and the limbs are the root of all Yang meridians. If headache is severe, pervasive through the brain, and accompanied by cold limbs reaching the joints, it indicates exhaustion of Primordial Yang and direct invasion of Yin pathogens into the Marrow Sea, representing the most ominous sign.)
For headaches caused by blows or falls, distant points should not be selected if there is internal stasis. If muscle pain persists, local needling may be performed, but distal Ying-Spring points should not be targeted. (Note: Headaches resulting from trauma often involve blood stasis within the collaterals. If pain persists, only the blood at the painful site should be drained. Distant Ying-Spring points should not be targeted to avoid damaging healthy Qi, as this is not a disease of the main meridians.)
Headaches that cannot be needled are those caused by severe Bi Syndrome (Painful Obstruction). Daily attacks can be slightly alleviated by needling but will not be completely cured. (Note: Severe Bi Syndrome is termed Da Bi. It results from the mixture of Wind, Cold, and Dampness, forming a malignant condition causing headache, which resists needling. If attacks occur daily, there are intervals, so needling can provide slight relief, but complete cure is impossible.)
Hemicranial cold pain requires first selecting the Hand-Shaoyang and Hand-Yangming meridians, followed by the Foot-Shaoyang and Foot-Yangming meridians. (Note: Hemicranial cold pain refers to unilateral cold headache. The meridians of the Hand and Foot Shaoyang and Yangming all traverse the ear and ascend to the temporal region. Thus, one should first select the Hand meridians to address the branch symptoms, then the Foot meridians to address the root cause.)