（一门，鹤年补集。）
头痛由于湿热上壅者颇多，然亦有因寒湿者。《金匮》所云∶头痛鼻塞而烦，其脉大，
自能
饮食，腹中和无病，病在头中寒湿，故鼻塞，纳药鼻中则愈。愚以为《本事》透顶散，正治
寒湿头痛之剂，否则丁香、细辛，治湿热头痛，无乃以火救火欤。
痰厥头痛者，病从脾而之胃也。夫脾主为胃行其津液者也，脾病则胃中津液不得宣行，
积而为痰，随阳明之经上攻头脑而作痛也。其证头重闷乱，眩晕不休，兀兀欲吐者是也。
半夏白术天麻汤 治太阴痰厥头痛，眼黑头旋，恶心烦乱，肢冷身重。
半夏 陈皮（去白） 麦芽（各七钱半） 神曲 白术（五钱，炒） 黄 （炙） 苍术（米泔
浸） 天麻 茯苓 人参 泽泻（各五钱半） 黄柏（二分，酒洗） 干姜（三分）
稍热服食前。一方加生姜一片。
《外台》云∶头痛非冷非风，此膈有痰也。浓煎茶啜一二升探吐之，吐已复吐，候苦汁
出乃止，不损人，待渴自止妙。
茶调散（子和）
瓜蒂、好茶二味，等分为末，每二钱，齑汁调，空心服之取吐。
半夏茯苓汤 治热痰呕逆头痛。
半夏（二钱） 赤苓（一钱） 陈皮（去白） 甘草（各五分） 黄芩（五分） 生姜（三片），煎
作一服。
头痛连眼痛，此风痰上攻，用雨前茶、川芎、白芷、防风、天台乌药、细辛、当归为
末，汤调服。
防风饮子 疗风痰气，发即头旋，呕吐不食。
防风 人参 橘皮（各二两） 白术 茯苓（各三两） 生姜（四两）
上锉碎，以水六升，煮取三升，去滓分温四服，一日服尽。忌醋、桃、李、雀肉、蒜、
面。
《直指方》云∶二陈汤加荆芥，治头风，兼治痰壅酒壅。又云∶头风证眉棱耳角俱痛，
投以风药不效，投以痰药收功，眼目赤肿羞明而痛，与之凉剂弗瘳，与之痰剂获愈也。
玉壶丸 治风痰吐逆，头痛目眩，胸膈烦满，饮食不下，及咳嗽痰盛，呕吐涎沫
。
南星（生） 半夏（各一两，生） 天麻（半两） 头白面（三两）
上为细末，滴水为丸，梧子大，每服三十丸。用水一大盏，先煎令沸，下药五七沸，候
药浮即熟，漉出放温，别用生姜汤下，不计时。一方有白术五钱，雄黄水飞三钱半。
东垣壮岁病头痛，每发时，两颊尽黄，眩晕，目不欲开，懒于言语，身体沉重，兀兀欲
吐，
数日方退。洁古老人曰∶此厥阴太阴合而为病，名曰风痰。以《局方》玉壶丸，加雄黄、白
术治之。
芎辛导痰汤 治痰厥头痛。
川芎 细辛 南星 陈皮（去白） 茯苓（各一钱半） 半夏（二钱） 枳实 甘草（各一钱）
上作一服，水二盅，姜七片，煎至一盅，食后服。
此导痰汤加川芎、细辛为引，使上行也。方殊简要。
（本门由鹤年补充收集。）
头痛由于湿热上壅的情况很多，但也有因寒湿引起的。《金匮要略》中说：头痛、鼻塞且心烦，脉象大，饮食正常，腹部调和无病，这是病在头中的寒湿，所以鼻塞，将药物纳入鼻中即可痊愈。我认为《本事方》中的透顶散，正是治疗寒湿头痛的方剂，否则使用丁香、细辛治疗湿热头痛，岂不是以火救火吗？
痰厥头痛，病源从脾传至胃。脾主为胃输送津液，脾病则胃中的津液不能宣通运行，积聚而成痰，随阳明经上行攻冲头脑而引发疼痛。其症状表现为头部沉重闷乱，眩晕不止，恶心欲吐。半夏白术天麻汤 治疗太阴痰厥头痛，眼黑头晕，恶心烦乱，四肢发冷身体沉重。
半夏 陈皮（去白） 麦芽（各七钱半） 神曲 白术（五钱，炒制） 黄芪（炙制） 苍术（米泔水浸泡） 天麻 茯苓 人参 泽泻（各五钱半） 黄柏（二分，酒洗） 干姜（三分）
稍热服用，饭前服。另一方案加生姜一片。
《外台秘要》说：头痛既非寒冷也非风邪，这是膈间有痰。浓煎茶饮用一二升以催吐，吐完再吐，等到吐出苦汁才停止，不伤人体，待口渴自然停止效果奇妙。
茶调散（张子和方）
瓜蒂、好茶两味药，等分为末，每次二钱，用醋汁调服，空腹服用以取吐。
半夏茯苓汤 治疗热痰引起的呕逆头痛。
半夏（二钱） 赤茯苓（一钱） 陈皮（去白） 甘草（各五分） 黄芩（五分） 生姜（三片），煎煮成一服量。
头痛连及眼痛，这是风痰上攻，用雨前茶、川芎、白芷、防风、天台乌药、细辛、当归研为末，用汤药调服。
防风饮子 治疗风痰气滞，发作时头晕目眩，呕吐不能进食。
防风 人参 橘皮（各二两） 白术 茯苓（各三两） 生姜（四两）
以上切碎，用水六升，煮取三升，去渣分四次温服，一天服完。忌食醋、桃、李、雀肉、蒜、面食。
《直指方》说：二陈汤加荆芥，治疗头风，兼治痰壅和酒壅。又说：头风证眉毛棱骨和耳角都痛，投用风药无效，投用化痰药收效；眼睛红肿畏光疼痛，给予凉剂不愈，给予化痰药却痊愈了。
玉壶丸 治疗风痰引起的吐逆，头痛目眩，胸膈烦闷胀满，饮食不下，以及咳嗽痰多，呕吐涎沫。
南星（生用） 半夏（各一两，生用） 天麻（半两） 头白面（三两）
以上研为细末，滴水为丸，如梧桐子大小，每次服三十丸。用水一大盏，先煎沸，下入药丸煮五七沸，候药丸浮起即熟，捞出放温，另用生姜汤送下，不拘时间。另一方案加白术五钱，雄黄水飞三钱半。
李东垣壮年时患头痛，每次发作时，两颊完全发黄，眩晕，眼睛不想睁开，懒于言语，身体沉重，恶心欲吐，数日后才消退。洁古老人说：这是厥阴和太阴合而为病，名叫风痰。用《局方》玉壶丸，加雄黄、白术治疗。
芎辛导痰汤 治疗痰厥头痛。
川芎 细辛 南星 陈皮（去白） 茯苓（各一钱半） 半夏（二钱） 枳实 甘草（各一钱）
以上作一服，用水二盅，生姜七片，煎至一盅，饭后服用。
此方是在导痰汤基础上加川芎、细辛作为引经药，使其上行。方子非常简要。
(This section was supplemented and collected by He Nian.)
Headaches caused by the upward congestion of damp-heat are quite common, yet there are also those caused by cold-dampness. The *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet) states: "Headache, nasal congestion, and irritability with a large pulse; if digestion is normal and the abdomen is harmonious without disease, the pathology lies in cold-dampness within the head, causing nasal congestion. Inserting medicine into the nose will cure it." I believe that Tou Ding San (Penetrating Top Powder) from the *Ben Shi Fang* (Prescriptions from the Capable Physician) is precisely the formula for treating cold-dampness headache. Otherwise, using Ding Xiang (Caryophylli Flos, Clove) and Xi Xin (Asari Radix et Rhizoma, Asarum) to treat damp-heat headache would be akin to saving fire with fire.
Tan Jue Tou Tong (Phlegm-Jue Headache) originates from the Spleen affecting the Stomach. The Spleen is responsible for transporting and transforming fluids for the Stomach. When the Spleen is diseased, the fluids in the Stomach cannot circulate freely, accumulating to form Phlegm (Tan). This phlegm ascends along the Yangming Meridian to attack the head, causing pain. The symptoms include a heavy and stuffy sensation in the head, continuous dizziness, and nausea with an urge to vomit. Ban Xia Bai Zhu Tian Ma Tang (Pinellia, Atractylodes Macrocephala, and Gastrodia Decoction) treats Taiyin Phlegm-Jue Headache, characterized by blurred vision, vertigo, nausea, irritability, cold limbs, and heaviness of the body.
Ban Xia (Pinelliae Rhizoma, Pinellia Tuber), Chen Pi (Citri Reticulatae Pericarpium, Tangerine Peel [scraped]), Mai Ya (Hordei Fructus Germinatus, Sprouted Barley) (each 7.5 qian), Shen Qu (Massa Medicata Fermentata, Medicated Leaven), Bai Zhu (Atractodis Macrocephalae Rhizoma, Atractylodes Macrocephala Rhizome) (5 qian, stir-fried), Huang Qi (Astragali Radix, Astragalus Root) (roasted), Cang Zhu (Atractodis Rhizoma, Atractylodes Rhizome) (soaked in rice wash water), Tian Ma (Gastrodiae Rhizoma, Gastrodia Rhizome), Fu Ling (Poria, Poria Cocos), Ren Shen (Ginseng Radix, Ginseng Root), Ze Xie (Alismatis Rhizoma, Alisma Rhizome) (each 5.5 qian), Huang Bo (Phellodendri Cortex, Phellodendron Bark) (2 fen, wine-washed), Gan Jiang (Zingiberis Rhizoma Recens, Dried Ginger) (3 fen).
Take slightly warm, before meals. Another variation adds one slice of Sheng Jiang (Zingiberis Rhizoma Recens, Fresh Ginger).
The *Wai Tai Mi Yao* (Important Prescriptions Worth a Thousand Gold) states: "Headache that is neither due to cold nor wind indicates phlegm in the diaphragm. Drink one or two sheng of strongly brewed tea to induce vomiting. Continue until bitter fluid is expelled, then stop. This does not harm the person; waiting for thirst to subside naturally yields excellent results."
Cha Tiao San (Tea-Powdering Powder, by Zhang Zihe)
Gua Di (Melonis Fructus, Melon Seed) and Hao Cha (Good Tea) in equal parts, powdered. Take 2 qian each time, mixed with vinegar juice, taken on an empty stomach to induce vomiting.
Ban Xia Fu Ling Tang (Pinellia and Poria Decoction) treats headache with retching caused by hot-phlegm.
Ban Xia (Pinelliae Rhizoma, Pinellia Tuber) (2 qian), Chi Ling (Poria cum Pino, Poria with Pine Wood) (1 qian), Chen Pi (Citri Reticulatae Pericarpium, Tangerine Peel [scraped]), Gan Cao (Glycyrrhizae Radix et Rhizoma, Licorice Root) (each 5 fen), Huang Qin (Scutellariae Radix, Scutellaria Root) (5 fen), Sheng Jiang (Zingiberis Rhizoma Recens, Fresh Ginger) (3 slices). Decoct as one dose.
If headache extends to eye pain, this is Wind-Phlegm attacking upwards. Use Yu Qian Cha (Pre-Rain Tea), Chuan Xiong (Ligustici Chuanxiong Rhizoma, Chuanxiong Rhizome), Bai Zhi (Angelicae Dahuricae Radix, Dahurian Angelica Root), Fang Feng (Saposhnikoviae Radix, Saposhnikovia Root), Tian Tai Wu Yao (Illicii Tenuifolii Fructus, Small-fruited Star Anise Fruit), Xi Xin (Asari Radix et Rhizoma, Asarum), and Dang Gui (Angelicae Sinensis Radix, Chinese Angelica Root) powdered, taken with decocted liquid.
Fang Feng Yin Zi (Saposhnikovia Decoction) treats Wind-Phlegm Qi stagnation, manifesting as vertigo and vomiting with inability to eat upon onset.
Fang Feng (Saposhnikoviae Radix, Saposhnikovia Root), Ren Shen (Ginseng Radix, Ginseng Root), Ju Pi (Citri Reticulatae Pericarpium, Tangerine Peel) (each 2 liang), Bai Zhu (Atractodis Macrocephalae Rhizoma, Atractylodes Macrocephala Rhizome), Fu Ling (Poria, Poria Cocos) (each 3 liang), Sheng Jiang (Zingiberis Rhizoma Recens, Fresh Ginger) (4 liang).
Chop finely, boil in 6 sheng of water to obtain 3 sheng, strain, and divide into four warm doses to be consumed within one day. Avoid vinegar, peaches, plums, sparrow meat, garlic, and wheat products.
The *Zhi Zhi Fang* (Directing the Source Prescriptions) states: Er Chen Tang (Two-Cured Decoction) plus Jing Jie (Schizonepetae Spica, Schizonepeta Spike) treats Tou Feng (Head Wind), and also addresses Phlegm congestion and Wine congestion. It further states: In Tou Feng syndrome where pain occurs at the brow ridge and ear angle, Wind-dispersing medicines are ineffective, whereas Phlegm-resolving medicines succeed. If eyes are red, swollen, photophobic, and painful, Cooling formulas fail, but Phlegm-resolving formulas bring recovery.
Yu Hu Wan (Jade Pot Pill) treats Wind-Phlegm causing retching, headache with vertigo, chest and diaphragm fullness and irritability, inability to eat, excessive coughing with phlegm, and vomiting of saliva/foam.
Nan Xing (Arisaematis Cum Bile, Arisaema with Bile) (raw, 1 liang), Ban Xia (Pinelliae Rhizoma, Pinellia Tuber) (raw, 1 liang), Tian Ma (Gastrodiae Rhizoma, Gastrodia Rhizome) (0.5 liang), Tou Bai Mian (White Wheat Flour) (3 liang).
Grind into fine powder, add water drop by drop to form pills the size of wutong seeds. Take 30 pills per dose. Use one large cup of water, boil first, add pills, boil for five to seven turns. When pills float, they are cooked. Strain out, let cool to warm, and take with another Ginger Decoction, regardless of timing. Another variation includes Bai Zhu (Atractodis Macrocephalae Rhizoma, Atractylodes Macrocephala Rhizome) 5 qian and Xiong Huang (Realgar, Realgar) water-triturated 3.5 qian.
Li Dongyuan suffered from headache in his prime. Upon each onset, both cheeks turned completely yellow, accompanied by vertigo, reluctance to open eyes, lethargy in speech, heaviness of the body, and nausea with an urge to vomit, subsiding only after several days. Ji Gu Lao Ren (Elder Ji Gu, i.e., Liu Wansu) said: "This is a combined disease of the Jueyin and Taiyin meridians, named Wind-Phlegm." Treat with Yu Hu Wan (Jade Pot Pill) from the *Ju Fang* (Formulary of the Bureau), adding Xiong Huang (Realgar, Realgar) and Bai Zhu (Atractodis Macrocephalae Rhizoma, Atractylodes Macrocephala Rhizome).
Xiong Xin Dao Tan Tang (Ligusticum and Asarum Guiding-Phlegm Decoction) treats Phlegm-Jue Headache.
Chuan Xiong (Ligustici Chuanxiong Rhizoma, Chuanxiong Rhizome), Xi Xin (Asari Radix et Rhizoma, Asarum), Nan Xing (Arisaematis Cum Bile, Arisaema with Bile), Chen Pi (Citri Reticulatae Pericarpium, Tangerine Peel [scraped]), Fu Ling (Poria, Poria Cocos) (each 1.5 qian), Ban Xia (Pinelliae Rhizoma, Pinellia Tuber) (2 qian), Zhi Shi (Aurantii Fructus Immaturus, Immature Bitter Orange), Gan Cao (Glycyrrhizae Radix et Rhizoma, Licorice Root) (each 1 qian).
Prepare as one dose, boil in two zhong of water with seven slices of ginger until reduced to one zhong. Take after meals.
This formula is Dao Tan Tang (Guiding-Phlegm Decoction) plus Chuan Xiong (Ligustici Chuanxiong Rhizoma, Chuanxiong Rhizome) and Xi Xin (Asari Radix et Rhizoma, Asarum) as guiding herbs to direct the action upwards. The prescription is remarkably concise.