典藏书目

Wei Qi (Defensive Qi) is the qi that warms the muscles, fills the skin, thickens the interstices (Cou Li), and controls the opening and closing of the pores. Therefore, when Wind Evil invades the Wei level, it inevitably causes aversion to wind. Aversion to wind and aversion to cold are both exterior syndromes, but aversion to wind is milder than aversion to cold. "Aversion to cold" refers to feeling chilly even without exposure to wind; "aversion to wind" means having no fear while residing in a sealed room or behind curtains, but shivering and feeling discomfort when exposed to wind or fanning oneself. Aversion to cold can be divided into Yin and Yang syndromes, whereas aversion to wind belongs exclusively to Yang syndromes. Thus, there is no aversion to wind in the Three Yin diseases.

Although aversion to wind is an exterior syndrome, its treatment for dispersing differs: if there is no sweating and aversion to wind, it is Cold Damage (Shang Han) and requires diaphoresis, so Mahuang Tang (Ephedra Decoction) is used; if there is sweating and aversion to wind, it is Wind Strike (Zhong Feng) and requires resolving the muscle layer, so Guizhi Tang (Cinnamon Twig Decoction) is used. Even if interior symptoms are present, as long as aversion to wind has not ceased, the exterior must be resolved first. Fever with aversion to wind indicates exterior deficiency and belongs to Taiyang Disease (see "Fever · Taiyang Disease"). After diaphoresis, if sweating continues unceasingly, resembling Wind-Dampness binding, with back aversion to wind, sweating, dysuria, and difficulty flexing/extending the limbs, but without epigastric fullness or body pain, Guizhi Jia Fuzi Tang (Cinnamon Twig Decoction plus Aconite) should be used (see "Spontaneous Sweating"). If it is Wind-Dampness binding, causing severe bone joint pain and pulling pain, Gancao Fuzi Tang (Licorice and Aconite Decoction) is used (formula see "Body Pain"). If there is fever, aversion to wind, neck stiffness, hypochondriac fullness, warm hands/feet, and thirst, Xiaochaihu Tang (Minor Bupleurum Decoction) is used (see "Hypochondriac Pain").

Headache caused by Cold Damage belongs to the Three Yang meridians, but is most common in the Taiyang meridian. This is because Taiyang disease is an exterior syndrome, and headache specifically indicates an exterior condition. Although there are cases of Cold Damage lasting six or seven days with headache, constipation, and heat signs treated with Chengqi Tang (Gut-Regulating Decoction) to purge, the text states, "If urine is clear, it indicates heat is not in the interior but remains in the exterior." This confirms that headache clearly belongs to the exterior. The TAIYIN and SHAOYIN meridians ascend from the foot to the chest and return, not reaching the head; therefore, their diseases do not involve headache. Only the JOUYIN meridian ascends along the throat, connects to the eye system, and meets the Du Meridian at the vertex, thus also causing headache. In the case of Wuzhuyu Tang (Evodia Decoction), dry vomiting and spitting of saliva occur without fever, which differs from Yang syndromes. However, in Wind-Warmth disease affecting Shaoyin and Damp-Warmth disease affecting Taiyin, headache may still occur; this shows one cannot rigidly adhere to fixed rules. Headaches due to internal causes have specific timing, while those due to external causes are constant until the pathogen enters the interior.

Fever, headache, and aversion to wind belong to Taiyang (formula theory see "Taiyang Disease · Fever"). If bowel movements are difficult, and after six or seven days there is headache, fever, and dark urine, Chengqi Tang is appropriate; if urination is smooth, the disease is not in the interior but remains in the exterior, requiring diaphoresis; if headache occurs, epistaxis will likely follow, and Guizhi Tang is indicated (theory see "Stomach Excess"). If, after taking Guizhi Tang or undergoing purgation, head and neck stiffness, mild fever, epigastric fullness with slight pain, and dysuria persist, Guizhi Qu Gui Jia Fuling Baizhu Tang (Cinnamon Twig Decoction minus Cinnamon Twig plus Poria and Atractylodes Macrocephala Decoction) is used (formula theory see "Neck Stiffness"). In Taiyang Wind Strike with diarrhea and vomiting, once the exterior is resolved, interior excess can be attacked. If the patient sweats intermittently, has headache, epigastric hardness radiating to the hypochondrium, dry retching, shortness of breath, sweating, and no aversion to cold, this indicates the exterior is resolved but the interior is disharmonious; Shizao Tang (Ten Date Decoction) is used (formula theory see "Hypochondriac Fullness and Pain").

Zhang Jingyue said: Some ask why both Shizao Tang and Guizhi Qu Gui Jia Fuling Baizhu Tang apply to patients with fluid retention who experience head and neck stiffness. This is due to meridian connections, not coincidence. The *Needle Classic* states: The Taiyang Bladder Meridian originates at the inner canthus, crosses the vertex; its branch goes from the vertex to the supra-auricular angle; the straight branch enters the brain from the vertex, emerges at the lower nape, follows the shoulder blades, runs alongside the spine to the waist, enters the muscles, connects to the Kidney, and belongs to the Bladder. The "connecting to Kidney" mentioned above refers to the Sanjiao (Triple Burner). The Sanjiao is the father of Yang Qi, the official of waterways, guiding Yin and Yang, opening blockages, and transforming Qi through water passages. Since the Taiyang meridian has abundant blood but scarce Qi, disease weakens the Qi further. At this time, with exterior pathology and mild interior heat causing slight thirst, excessive drinking of fluids overwhelms the weak Qi's transformative power, causing fluid retention internally. This stagnates the blood and Qi of the primary meridian, leading to headache and neck stiffness. If the retained fluid circulates and the meridians are cleared, the headache resolves spontaneously.

Wang Haogu said: In Warm disease, if there is fever, headache, and a deep pulse, and if it does not improve with body pain, the interior must be rescued using Sini Tang (Frigid Extremities Decoction) (theory see "Fever"). In Taiyang disease, headache may resolve spontaneously after seven days because the meridian cycle is complete. To prevent transmission to the next stage, needle the Foot-Yangming meridian to stop transmission. (Cold Damage transmits through the Three Yang and Three Yin meridians over six days and should resolve on the seventh day. The Classic says: On the seventh day, Taiyang disease declines, and headache lessens. If it does not resolve, Taiyang evil transmits to Yangming; needling Foot-Yangming to drain excess stops transmission.) Wu Kun said: Floating pulse with headache indicates Taiyang; needle Waangu (SI4) and Jinggu (BL64). Also, for exterior syndrome headache with aversion to cold and fever, needle Hegu (LI4).

Yangming disease (Harmonizing method): Body heat, headache, rinsing mouth without swallowing, likely epistaxis, rapid pulse: use Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) and Maohua Tang (Thistle Flower Decoction) (see "Epistaxis"). Yangming disease with severe interior/exterior heat, irritability, thirst, and crushing headache: use Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction). Yangming headache with aversion to heat rather than cold, solid stool: use Weitiao Chengqi Tang (Gentle Gut-Regulating Decoction). Yangming disease with anhidrosis but smooth urination, vomiting, cough, and cold extremities after two or three days implies severe headache; if no vomiting/cough and warm extremities, no headache. (*Inner Classic*: Juyang [Taiyang] receives evil, Shaoyin is interior; heat ascends causing cold extremities. Taiyang and Shaoyin are paired; this case suggests Taiyang is not fully resolved. Another classic says: Yangming involves panting... aversion to people. Smooth urination indicates internal cold attack; cold extremities and headache indicate external cold attack.)

Wu Kun said: Yangming headache, frontal orbital pain, nasal dryness, long pulse, anhidrosis: use Gegen Tang (Kudzu Decoction) plus Congbai (Scallion White) and Baizhu (Angelica Dahurica) to induce sweating. If sweating occurred previously and headache persists, use Gegen Congbai Tang (Kudzu and Scallion White Decoction). If no aversion to wind but aversion to heat, spontaneous sweating, irritability, thirst, rapid/huge pulse, and headache upon drinking: use Baihu Jia Baizhu Tang (White Tiger Plus Angelica Dahurica Decoction). If dry feces cause steaming fever and headache: use Weitiao Chengqi Tang. For Yangming headache with anhidrosis, use Gegen, Mahuang, Congbai, Baizhu, Shigao (Gypsum); for sweating, use Baizhu, Shigao, Gegen, Chuanxiong Tang.

Cold Damage (Harmonizing method): String-tight/fine pulse, headache, fever belong to Shaoyang; do not induce sweating, as this leads to delirium. This relates to the Stomach; if Stomach harmonizes, recovery occurs; if not, irritability and palpitations ensue. Use Xiaochaihu Tang (theory see "Bitter Taste").

Wu Kun said: Shaoymeridian headache, temporal or ear pain, string-tight/rapid pulse, bitter taste, alternating chills and fever: use Xiaochaihu Tang to harmonize. Adding Chuanxiong (Ligusticum) is excellent as it enters the Gallbladder meridian. For all Shaoyang headaches, regardless of sweating, use Chaihu Tang. Intermittent headache with chills/fever and tight/small pulse indicates phlegm in the upper jiao; use Gengti San (Seed Melon Powder) to induce vomiting.

Headache with dry vomiting and spitting saliva: Wuzhuyu Tang (formula theory see "Vomiting"). *Li Ren Shu* says: Jouyin headache indicates impending recovery; use Xiaojianzhong Tang (Minor Construct the Middle Decoction).

Li Dongyuan said: For headache like breaking, whether after sweating or not, use Lianxu Congbai Tang (Scallion White with Roots Decoction).

**Lianxu Congbai Tang Formula**: Scallion White with roots (half sheng, cut), Ginger (two liang). Boil in two sheng of water to obtain one sheng; take warm in two doses. If ineffective, use the following formula.

**Gegen Congbai Tang Formula**: Gegen (Kudzu Root), Shaoyao (Peony Root), Zhimu (Anemarrhena Rhizome) (each half liang); Chuanxiong (Sichuan Lovage Rhizome), Congbai (Scallion White), Shengjiang (Fresh Ginger) (each one liang). Boil in three sheng of water to obtain one sheng; take hot. For intermittent headache, chest fullness, chills/fever, and tight/small pulse indicating phlegm in the jiao, use one qian of Gengdi powder mixed with warm water to induce vomiting of phlegm for immediate relief.

*Li Ren Shu* says: For headache and vertigo after sweating/purgation in Cold Damage, use Duhuo Tang (Angelica Pubescens Decoction). Fangfeng (Siler Root), Duhuo (Angelica Pubescens Root), Xuanjinhua (Inula Flower), Danggui (Angelica Sinensis Root) (each seven qian). Chew slightly, decoct with ginger water.

For persistent headache after febrile disease, use Shigao Chuanxiong Tang (Gypsum and Ligusticum Decoction). Shigao (Gypsum), Chuanxiong (each one liang). Chew slightly, take five qian per dose, decoct in water.

Zhu Danxi said: Taiyang headache with sweating uses Guizhi Tang; without sweating, Mahuang Tang. Yangming headache uses Baihu Tang. Shaoyang headache uses Xiaochaihu Tang. Taiyin headache: floating pulse uses Guizhi Tang; deep pulse uses Lizhong Tang; both add Chuanxiong and Xixin. Shaoyin headache uses Xiaochaihu Tang or Mahuang Fuzi Xixin Tang. Jouyin headache involving external injury to the primary meridian uses Guizhi Mahuang Gehan Tang (Half-Half Decoction of Cinnamon Twig and Ephedra). Vomiting with slight bitter fluid regurgitation uses Wuzhuyu Tang.

Li Gao (Yuan) said: Taiyin headache always involves phlegm; Shaoyin headache involves cold feet and rebellious Qi. Although Taiyin and Shaoyin meridians do not reach the head, phlegm and rebellious Qi obstructing the chest prevent Qi from descending smoothly to the head, causing pain.

*Li Ren Shu* says: For floating pulse with headache, affect Hand/Foot-Taiyang; needle WanGu (SI4) and Jinggu (BL64). For floating/long pulse, affect Hand/Foot-Yangming; needle Hegu (LI4) and Chongyang (ST42). For floating/string-tight pulse, affect Hand/Foot-Shaoyang; needle Yangchi (TE4), Qiuxu (GB40), Fengfu (DU16), Fengchi (GB20). These are methods for needling headache.

*Yi Zong Jin Jian* collection notes: For Cold Damage headache, needle Gu (LI15?) and Zanzhu (BL2).