脉∶头痛阳弦；浮风紧寒；热必洪数，湿细而坚；气虚头痛，虽弦带数；痰厥则滑；肾厥坚实。
头者，诸阳之首也。其痛有各经之不同，因而治法亦有异也。气虚头痛者，耳鸣、九窍不利也。湿热头痛
者，头重如石，属湿也。风寒头痛者，身重恶寒，寒邪从外入，宜汗之也。偏头痛者，手少阳、阳明经受症；
左半边属火、属风、属血虚；右半边属痰、属热也。真头痛者，脑尽而疼。手足冷至节者，不治也。少阳头痛
者，往来寒热也；阳明头痛者，自汗发热恶寒也；太阳头痛者，有痰重或腹痛，为之痰癖也；少阴经痛者，三
阴三阳经不流行而足寒，气逆为寒也；厥阴头痛者，或痰多厥冷也；血虚头痛者，夜作苦者是也。眉轮骨痛，
痰火之征也；又云风热与痰也。有汗虚羞明眉眶痛者，亦痰火之征也。
肥人头痛者，多是气虚湿痰也。二陈汤（方见痰饮。）根据本方加人参、白术、川芎、白芷、细辛、羌活、
桔梗、荆芥。
瘦人头痛者，多是血虚痰火也。二陈汤（方见痰饮。）根据本方加生地黄、当归、片芩、川芎、细辛、羌活、
桔梗。
遇风寒恶心呕吐者，乃头风也。二陈汤（方见痰饮。）
头痛偏左者，属风与血虚也。
当归补血汤 治血虚与风头痛。
当归 川芎 白芍药 生地黄 枯芩（酒炒） 香附（酒炒。各
一钱） 防风 蔓荆子 柴胡（各五分） 荆芥 本（各四分）
上锉一剂，水煎服。
加味四物汤 治血虚阴火冲上头痛。
当归 川芎 生地黄 黄柏（酒炒） 知母（酒炒） 蔓荆子 黄芩（酒炒） 黄连（酒炒） 栀子（炒。
各等分）
上锉一剂，水煎服。
头痛偏右者，属痰与气虚也。
黄 益气汤 治气虚头痛。
黄 （一钱，蜜炒） 人参 白术 陈皮 半夏（姜汁炒） 当归（酒炒） 川芎 本 甘草（炙。各
五分） 升麻 黄柏（酒炒） 细辛（各三分）
上锉一剂，姜三片，水煎服。
头痛左右俱疼者，气血两虚也。
调中益气汤 治气血两虚头痛。
黄 人参 甘草（炙） 苍术（米泔浸，炒） 川芎（各六分） 升麻 柴胡 陈皮 黄柏（酒炒）
蔓荆子（各三分） 当归（六分） 细辛（二分）
上锉一剂，水煎服。
头旋眼黑恶心者，痰厥头痛也。
半夏白术天麻汤 治痰厥头痛、眼黑头旋、恶心烦闷、气短促、上喘无力语言、心神颠倒、目不敢开，
如在风云之中，头苦痛如裂、身重如山、四肢厥冷、不得安卧，此乃胃气虚损，停痰而致也。
半夏（姜汁制） 陈皮（去白） 麦芽（各七分半） 白茯苓（去皮） 黄 （蜜水炒） 人参 泽泻
苍术（米泔浸） 天麻（各三分半） 神曲（五分，炒） 黄柏（酒炒） 干姜（炒。各二分）
上锉一剂，生姜三片，水煎，食前热服。
偏正头痛者，风气上攻也。
川芎茶调散 治诸风上攻，头目昏沉、偏正头痛、鼻塞
声重、伤风壮热、肢体酸疼、肌肉蠕动、膈热痰盛、妇人血气攻疰、太阳穴痛，俱是外感风气，并效。
川芎 荆芥穗（各二两） 薄荷 香附（各四两） 羌活 白芷 甘草（炙。各一两） 防风（七钱半）
上为细末，每服二钱，食后茶清调下，姜、葱煎汤亦可。一方加菊花一两、细辛五钱、僵蚕、蝉蜕各二钱半
，名菊花茶调散。
热厥头痛者，见寒暂止也。
清上泻火汤 治热厥头痛，虽冬天严寒，犹喜风寒，其痛暂止。来暖处或见烟火，则痛复作。
当归 蔓荆子 苍术（米泔浸） 羌活 柴胡（各二钱） 川芎 生地黄 黄连（酒炒） 荆芥穗 本
（各五钱） 防风 升麻 细辛 黄 黄柏（酒炒） 知母（酒炒） 红花 黄芩 炙甘草（各一钱） 生甘
草（五钱）
上锉，每剂一两二钱，水煎，食远稍热服。
颈项强痛者，风所干也。
回首散 治颈攻强急、筋痛，或挫颈、转项不得者。乌药顺气散加羌活、独活、木瓜。（方见中风。）
眉棱骨痛者，风热并痰也。
选奇方
羌活 防风（各二钱） 酒片芩（一钱半，冬月不用，或少者炒用） 半夏（姜汁炒，二钱） 甘草（一钱，
夏月生，冬月炙）
上锉一剂，水煎食后服。
雷头风者，头痛而起核块也。
升麻汤 治失面疙瘩、憎寒、拘急、发热，状如伤寒。
升麻 苍术 薄荷叶（各等分）
上锉，水煎服，或茶调散亦效。
一切头痛总治之药也。
六圣散 即是赤火金针，治头风牙痛、赤眼脑泻耳鸣、偏正头风头疼、鼻塞声重及蜈蚣蛇蝎所伤。
用时口噙凉水，以药搐鼻。此药名为六圣。乳香没药川芎，雄黄白芷二钱停，半两盆硝共享，右件研为细末，
专治眼泪头风、耳鸣鼻塞脑不宁，一搐牙痛便定。
七生丸 治男妇八般头痛及一切头痛，痰厥、肾厥，伤寒伤风头痛，并皆治之。
川芎 川乌（去皮） 草乌（去皮） 南星（去皮） 半夏（冷水洗去滑） 白芷 石膏（俱生。各等分）
加细辛、全蝎各减半。
上为细末，研韭菜自然汁为丸，如梧桐子大。每服七丸或十丸，嚼生葱茶送下。
治六经头痛，诸药不效者。
栀子（炒） 条芩（炒） 连翘（三味为君） 川芎 白芷 知母 黄柏（酒炒） 薄荷 生地黄（酒洗，
六味俱为臣） 柴胡 桔梗（二味为佐） 香附米 甘草（二味为使） 石膏（二匙） 细茶（一撮）
上锉，水煎，食后频热服。
侍御西泉杜公，患头痛如刀劈，不敢动移，惧风，怕言语，耳鸣，目中溜火，六脉紧数有力。余以酒九蒸
九晒大黄为末三钱，茶调服，一剂而愈。
刘毅斋但怒则两太阳作痛，先用小柴胡汤（方见伤寒） 加茯苓、山栀，后用六味丸（方见补益），以生
肾水而不再发。
谭侍御每头痛必吐清水，不拘冬夏，吃姜便止。余作中气虚寒，用六君子汤加当归、黄 、木香、炮姜而
瘥。（方见补益。）
商仪部劳则头痛。余作阳虚不能上升，以补中益气汤加蔓荆子而痊。（方见补益。）
Pulse: In headache, the pulse is wiry (Xian) in Yang conditions; floating (Fu) indicates wind, tight (Jin) indicates cold; heat必定 presents with surging and rapid (Hong Shu) pulses, while dampness presents with fine and firm pulses. Headache due to Qi deficiency shows a wiry pulse with rapidity; phlegm-jue presents with a slippery (Hua) pulse; kidney-jue presents with a firm and solid pulse.
The head is the gathering place of all Yang meridians. The manifestations of headache differ among meridians, and thus treatment methods vary accordingly. Headache due to Qi deficiency is accompanied by tinnitus and dysfunction of the nine orifices. Headache due to damp-heat presents with a heavy sensation in the head as if weighted by a stone, attributed to dampness. Headache due to wind-cold presents with body heaviness and aversion to cold; since the cold pathogen enters from the exterior, diaphoresis (sweating method) is indicated. Migraine (lateral headache) involves the Hand Shaoyang and Yangming meridians; left-sided headache is attributed to fire, wind, or blood deficiency; right-sided headache is attributed to phlegm or heat. True headache (Zhen Tou Tong) involves pain reaching the brain. When hands and feet are cold up to the joints, it is incurable. Shaoyang headache presents with alternating chills and fever; Yangming headache presents with spontaneous sweating, fever, and aversion to cold; Taiyang headache presents with excessive phlegm or abdominal pain, termed "phlegm-pi"; Shaoyin meridian headache presents with non-circulation of the three Yin and three Yang meridians, cold feet, and cold symptoms due to rebellious Qi; Jueyin headache presents with excessive phlegm or cold extremities. Blood deficiency headache is characterized by worsening pain at night. Pain in the supraorbital ridge is a sign of phlegm-fire; some attribute it to wind-heat and phlegm. Symptoms of sweating, photophobia, and orbital pain are also signs of phlagm-fire.
In obese individuals, headache is mostly due to Qi deficiency and damp-phlegm. Use Er Chen Tang (see Phlegm-Fluids). Add Ginseng Radix (Renshen), Atractylodis Rhizoma (Baizhu), Ligusticum Chuanxiong Rhizome (Chuanxiong), Angelica Dahurica Root (Baizhi), Asari Radix et Rhizoma (Xixin), Notopterygii Rhizoma et Radix (Qianghuo), Platycodonis Radix (Jiegeng), and Schizonepetae Herba (Jingjie) to this formula.
In thin individuals, headache is mostly due to blood deficiency and phlegm-fire. Use Er Chen Tang (see Phlegm-Fluids). Add Rehmanniae Radix (Shengdihuang), Angelica Sinensis Radix (Danggui), Scutellariae Radix (Huangqin), Ligusticum Chuanxiong Rhizome (Chuanxiong), Asari Radix et Rhizoma (Xixin), Notopterygii Rhizoma et Radix (Qianghuo), and Platycodonis Radix (Jiegeng) to this formula.
Headache accompanied by nausea and vomiting upon exposure to wind-cold is Wind-Cold Headache (Tou Feng). Use Er Chen Tang (see Phlegm-Fluids).
Headache偏向 left is attributed to wind and blood deficiency.
Dang Gui Bu Xue Tang (Angelica Tonifying Blood Decoction): Treats headache due to blood deficiency and wind.
Ingredients: Dang Gui, Chuanxiong, Bai Shao Yao, Sheng Di Huang, Ku Qin (stir-fried with wine), Xiang Fu (stir-fried with wine, 1 qian each), Fang Feng, Man Jing Zi, Chai Hu (0.5 qian each), Jing Jie, Ben Cao (0.4 qian each).
Crush into one dose, decoct with water, and take orally.
Jia Wei Si Wu Tang (Modified Four Substances Decoction): Treats headache due to blood deficiency and deflection of yin-fire upward.
Ingredients: Dang Gui, Chuanxiong, Sheng Di Huang, Huang Bo (stir-fried with wine), Zhi Mu (stir-fried with wine), Man Jing Zi, Huang Qin (stir-fried with wine), Huang Lian (stir-fried with wine), Zhi Zi (stir-fried, equal parts).
Crush into one dose, decoct with water, and take orally.
Headache偏向 right is attributed to phlegm and Qi deficiency.
Huang Qi Yi Qi Tang (Astragalus Boosting Qi Decoction): Treats headache due to Qi deficiency.
Ingredients: Huang Qi (1 qian, honey-stir-fried), Ren Shen, Bai Zhu, Chen Pi, Ban Xia (stir-fried with ginger juice), Dang Gui (stir-fried with wine), Chuanxiong, Ben Cao, Gan Cao (roasted, 0.5 qian each), Sheng Ma, Huang Bo (stir-fried with wine), Xi Xin (0.3 qian each).
Crush into one dose, add three slices of fresh ginger, decoct with water, and take orally.
Headache affecting both left and right sides is attributed to dual deficiency of Qi and blood.
Tiao Zhong Yi Qi Tang (Regulating Middle and Boosting Qi Decoction): Treats headache due to dual deficiency of Qi and blood.
Ingredients: Huang Qi, Ren Shen, Gan Cao (roasted), Cang Zhu (soaked in rice wash water and stir-fried), Chuanxiong (0.6 fen each), Sheng Ma, Chai Hu, Chen Pi, Huang Bo (stir-fried with wine), Man Jing Zi (0.3 fen each), Dang Gui (0.6 fen), Xi Xin (0.2 fen).
Crush into one dose, decoct with water, and take orally.
Vertigo, blurred vision, and nausea indicate Phlegm-Jue Headache.
Ban Xia Bai Zhu Tian Ma Tang (Pinellia, Atractylodes, and Gastrodia Decoction): Treats phlegm-jue headache, blackouts, vertigo, nausea, restlessness, shortness of breath, weak speech, mental confusion, inability to open eyes, feeling as if in wind and clouds, severe splitting headache, heavy body like a mountain, cold limbs, and insomnia. This results from stomach Qi deficiency and retention of phlegm.
Ingredients: Ban Xia (processed with ginger juice), Chen Pi (peeled), Mai Ya (0.75 qian each), Bai Fu Ling (peeled), Huang Qi (stir-fried with honey water), Ren Shen, Ze Xie, Cang Zhu (soaked in rice wash water), Tian Ma (0.35 qian each), Shen Qu (0.5 qian, stir-fried), Huang Bo (stir-fried with wine), Gan Jiang (roasted, 0.2 qian each).
Crush into one dose, add three slices of fresh ginger, decoct with water, and take hot before meals.
Lateral and frontal headaches are caused by wind qi attacking upward.
Chuan Xiong Cha Tiao San (Ligusticum Tea-Powder for Directing Downward): Treats various wind pathogens attacking upward, causing dizziness, lateral and frontal headaches, nasal congestion, heavy voice, wind-cold with high fever, limb soreness, muscle twitching, chest heat with excessive phlegm, women's blood-qiu attacks, and temporal pain. All are due to external wind invasion and respond well to this formula.
Ingredients: Chuanxiong, Jing Jie Sui (2 liang each), Bo He, Xiang Fu (4 liang each), Qiang Huo, Bai Zhi, Gan Cao (roasted, 1 liang each), Fang Feng (7.5 qian).
Grind into fine powder. Take 2 qian per dose after meals, mixed with clear tea. Ginger and scallion decoction can also be used. Another prescription adds Ju Hua (1 lian), Xi Xin (5 qian), Jiang Can, and Chan Tui (2.5 qian each), named Ju Hua Cha Tiao San.
Heat-Jue headache stops temporarily upon exposure to cold.
Qing Shang Xie Huo Tang (Clear Upper and Purge Fire Decoction): Treats heat-jue headache. Even in severe winter cold, the patient prefers wind and cool air, and pain stops temporarily. In warm places or near smoke/fire, pain recurs.
Ingredients: Dang Gui, Man Jing Zi, Cang Zhu (soaked in rice wash water), Qiang Huo, Chai Hu (2 qian each), Chuanxiong, Sheng Di Huang, Huang Lian (stir-fried with wine), Jing Jie Sui, Ben Cao (5 qian each), Fang Feng, Sheng Ma, Xi Xin, Huang Qi, Huang Bo (stir-fried with wine), Zhi Mu (stir-fried with wine), Hong Hua, Huang Qin, Zhi Gan Cao (1 qian each), Sheng Gan Cao (5 qian).
Crush. Each dose is 1.2 liang. Decoct with water and take slightly hot long after meals.
Stiffness and pain in the neck and nape are caused by wind disturbance.
Hui Shou San (Turning Head Powder): Treats neck stiffness, spasm, tendon pain, or inability to turn the head due to strain. It is Wu Yao Shun Qi San plus Qiang Huo, Du Huo, and Mu Gua. (See Stroke section.)
Pain in the supraorbital ridge is due to wind-heat combined with phlegm.
Xuan Qi Fang (Selecting Marvelous Formula)
Ingredients: Qiang Huo, Fang Feng (2 qian each), Jiu Pian Qin (1.5 qian, not used in winter or stir-fried if small amount), Ban Xia (stir-fried with ginger juice, 2 qian), Gan Cao (1 qian, raw in summer, roasted in winter).
Crush into one dose, decoct with water, and take after meals.
Lei Tou Feng (Thunderhead Wind) presents with headache and nodules.
Sheng Ma Tang (Cimicifugae Decoction): Treats facial papules, aversion to cold, spasms, and fever resembling cold damage.
Ingredients: Sheng Ma, Cang Zhu, Bo He Ye (equal parts).
Crush, decoct with water, or use Chuan Xiong Cha Tiao San which is also effective.
A general remedy for all types of headache.
Liu Sheng San (Six Saints Powder), also known as Chi Huo Jin Zhen. Treats wind-headache toothache, red eyes, cerebral discharge, tinnitus, lateral/frontal wind-headache, nasal congestion, and injuries from centipedes, snakes, and scorpions.
Usage: Hold cool water in mouth, insufflate powder into nose. Ingredients: Ru Xiang, Mo Yao, Chuanxiong, Xiong Huang, Bai Zhi (2 qian each), Pen Xiao (0.5 liang). Grind into fine powder. Specifically treats tearing, wind-headache, tinnitus, nasal congestion, and restless mind; toothache stops immediately after insufflation.
Qi Sheng Wan (Seven Raw Pills): Treats eight types of headache in men and women, all headaches, phlegm-jue, kidney-jue, cold damage, and wind-cold headaches.
Ingredients: Chuanxiong, Chuan Wu (peeled), Cao Wu (peeled), Nan Xing (peeled), Ban Xia (washed in cold water to remove slipperiness), Bai Zhi, Shi Gao (all raw, equal parts).
Add Xi Xin and Quan Xie, halving their amounts.
Grind into powder, mix with fresh leek juice to form pills the size of paulownia seeds. Take 7 or 10 pills per dose, chewed with raw scallion and washed down with tea.
For six-meridian headaches unresponsive to other medicines.
Ingredients: Zhi Zi (roasted), Tiao Qin (roasted), Lian Qiao (these three are Sovereign drugs); Chuanxiong, Bai Zhi, Zhi Mu, Huang Bo (stir-fried with wine), Bo He, Sheng Di Huang (wine-washed, these six are Minister drugs); Chai Hu, Jie Geng (these two are Assistant drugs); Xiang Fu Mi, Gan Cao (these two are Envoy drugs); Shi Gao (2 spoons), Xi Cha (a pinch).
Crush, decoct with water, and take frequently hot after meals.
Du Gong, a Retainer, suffered from headache as if split by a knife, unable to move, afraid of wind and speech, with tinnitus and eyes appearing to emit fire. His six pulses were tight, rapid, and forceful. I used Da Huang processed with nine steamings and nine dryings, ground into powder (3 qian), taken with tea. One dose cured him.
Liu Yizhai experienced pain in both temples whenever angry. First, Xiao Chai Hu Tang (Minor Bupleurum Decoction, see Cold Damage) was added with Fu Ling and Shan Zhi. Later, Liu Wei Wan (Six Ingredient Pill, see Tonification) was used to nourish Kidney Water and prevent recurrence.
Tan Shiyu always vomited clear fluid when suffering from headache, regardless of season, relieved by eating ginger. I diagnosed it as Middle Qi deficiency and cold, using Liu Jun Zi Tang (Six Gentlemen Decoction) added with Dang Gui, Huang Qi, Mu Xiang, and Pao Jiang. Cured. (See Tonification section.)
Shang Yibu suffered headache after exertion. I diagnosed it as Yang deficiency failing to ascend, using Bu Zhong Yi Qi Tang (Tonify the Middle and Boost Qi Decoction) added with Man Jing Zi. Cured. (See Tonification section.)