徐（六七） 冬月呕吐之后。渐渐巅顶作痛。下焦久有积疝痔疡。厥阴阳明偏热。凡阳气过动。变化火
风。迅速自为升降。致有此患。（风火）
连翘心 元参心 桑叶 丹皮 黑山栀皮 荷叶汁
胡（六三） 脉左弦数。右偏头痛左齿痛。
连翘 薄荷 羚羊角 夏枯草花 黑栀皮 鲜菊叶
苦丁茶 干荷叶边
某 高年气血皆虚。新凉上受。经脉不和。脑后筋掣牵痛。倏起倏静。乃阳风之邪。议用清散轻
剂。
荷叶边 苦丁茶 蔓荆子 菊花 连翘
王（六三） 邪郁。偏头痛。
鲜荷叶边（三钱） 苦丁茶（一钱半） 连翘（一钱半） 黑山栀（一钱） 蔓荆子（一钱） 杏
仁（二钱） 木通（八分） 白芷（一分）
郁（五十） 风郁头疼。
鲜荷叶 苦丁茶 淡黄芩 黑山栀 连翘 蔓荆子 木通 白芷
某（四七） 内风头痛泪冷。（肝风）
炒杞子 制首乌 柏子仁 茯神 炒菊花炭 小黑 豆皮
沈（氏） 痛在头左脑后。厥阳风木上触。
细生地 生白芍 柏子仁 炒杞子 菊花 茯神
孙（二四） 暑伏。寒热头痛。（伏暑）
鲜荷叶边 连翘 苦丁茶 夏枯草 山栀 蔓荆子 浓朴 木通
某 暑风湿热。混于上窍。津液无以营运。凝滞。遂偏头痛。舌强干涸。治宜清散。
连翘 石膏 生甘草 滑石 蔓荆子 羚羊角 荷梗 桑叶
程 既知去血过多。为阴虚阳实之头痛。再加发散。与前意相反矣。（血虚阳浮）复脉去参姜桂加
左牡蛎
又 脉数虚而动。足征阴气大伤。阳气浮越。头痛筋惕。仍与镇摄之法。
牡蛎 阿胶 人参 生地 炙草 白芍 天冬
朱 据说就凉则安。遇暖必头痛筋掣。外以摩掐可缓。大凡肝风阳扰。胃络必虚。食进不甘。是
中焦气馁。虽咸润介属潜阳获效。说来依稀想像。谅非入理深谈。聊以代煎。酸甘是商。且五
旬又四。中年后矣。沉阴久进。亦有斫伐生气之弊。半月来。乏少诊之功。姑为认慎。用固本膏。
（肝阳犯胃上逆）
徐 当年下虚。曾以温肾凉肝获效。春季患目。是阳气骤升。乃冬失藏聚。水不生木之征也。频
以苦辛治目。风阳上聚头巅。肝木横扰。胃受戕贼。至于呕吐矣。今心中干燥如焚。头中岑岑
震痛。忽冷忽热。无非阴阳之逆。肝为刚脏温燥决不相安。况辛升散越转凶。岂可再蹈前辙。
姑以镇肝益虚。冀有阳和风熄之理。
阿胶 小麦 麦冬 生白芍 北沙参 南枣
又 倏冷忽热。心烦巅痛。厥阳之逆。已属阴液之亏。前案申明刚药之非。代赭味酸气坠。乃强
镇之品。亦刚药也。考七疝中。子和惯投辛香走泄。其中虎潜一法亦采。可见疝门亦有柔法。
医者熟汇成法。苟不潜心体认。皆希图附会矣。今呕逆既止。其阴药亦有暂投。即水生涵木
之法。议以固本成方。五更时从阳引导可也。加秋石。
叶（妪） 临晚头痛。火升心嘈。风阳上冒。防厥。
细生地 阿胶 牡蛎 茯神 麦冬 生白芍
史 头形象天。义不受浊。今久痛有高突之状。似属客邪蒙闭清华气血。然常饵桂附河车。
亦未见其害。思身半以上属阳。而元首更为阳中之阳。大凡阳气先虚。清邪上入。气血瘀痹。
其痛流连不息。法当宣通清阳。勿事表散。以艾 按法灸治。是一理也。（厥阴气血邪痹）
熟半夏 北细辛 炮川乌 炙全蝎 姜汁
又 阳气为邪阻。清空机窍不宣。考周礼采毒药以攻病。藉虫蚁血中搜逐。以攻通邪结。乃古
法。而医人忽略者。今痛滋脑后。心下呕逆。厥阴见症。久病延虚。攻邪须兼养正。
川芎 当归 半夏 姜汁 炙全蝎 蜂房
张（二二） 太阳痛。连颧骨耳后牙龈。夏令至霜降不痊。伏邪未解。治阳明少阳。（胆胃伏邪）
连翘 羚羊角 牛蒡子 葛根 赤芍 白芷 鲜菊叶
头为诸阳之会。与厥阴肝脉会于巅。诸阴寒邪不能上逆为阳气窒塞。浊邪得以上据。
厥阴风火。乃能逆上作痛。故头痛一症。皆由清阳不升。火风乘虚上入所致。观先生于头
痛治法。亦不外此。如阳虚浊邪阻塞。气血瘀痹而为头痛者。用虫蚁搜逐血络。宣通阳气
为主。如火风变动。与暑风邪气上郁而为头痛者。用鲜荷叶苦丁茶蔓荆山栀等。辛散轻
清为主。如阴虚阳越而为头痛者。用仲景复脉汤。甘麦大枣法。加胶芍牡蛎。镇摄益虚。和
阳熄风为主。如厥阳风木上触。兼内风而为头痛者。用首乌柏仁 豆甘菊生芍杞子辈。
熄肝风。滋肾液为主。一症而条分缕析。如此详明。可谓手法兼到者矣。（邹时乘）
徐评 头风一症。往往本热而标寒。案中多清火之药。固能愈风火轻症。或有寒邪犯脑。或有
风寒外束。则温散之法。固不可略。而外提之法。尤当博考也。
Xu (67 years old): After vomiting in the winter month, pain gradually developed at the vertex. There has long been accumulated hernia and hemorrhoidal ulcers in the lower jiao. The Jueyin and Yangming meridians are biased towards heat. Whenever yang qi moves excessively, it transforms into fire and wind, rising and descending rapidly on its own, leading to this affliction. (Wind-Fire Syndrome)
Lianqiao Xin (Forsythiae Fructum Heart), Yuanshen Xin (Scrophulariae Radix Heart), Sangye (Mori Folium), Danpi (Moutan Cortex), Heishanzhi Pi (Gardeniae Fructum Bark), Heye Zhi (Nelumbinis Petiolus Juice).
Hu (63 years old): The pulse is wiry and rapid on the left; right-sided headache and left-sided toothache.
Lianqiao (Forsythiae Fructum), Bohe (Menthae Haplocalycis Herba), Lingyangjiao (Saigae Tataricae Cornu), Xiakucao Hua (Prunellae Spica), Heizhipi (Gardeniae Fructum Bark), Xianjuye (Chrysanthemi Indici Folium), Kudingcha (Ilicis Kudingchae Folium), Ganheyebian (Dried Nelumbinis Petiolus Margin).
Certain patient: An elderly person with deficiency of both qi and blood, newly affected by cool pathogen, disharmony of meridians and collaterals, twitching and pulling pain in the tendons at the back of the head, arising suddenly and subsiding suddenly. This is the pathogen of Yang-Wind. It is proposed to use a light clearing and dispersing formula.
Heyebian (Nelumbinis Petiolus Margin), Kudingcha (Ilicis Kudingchae Folium), Manjingzi (Vittariae Spora), Juhua (Chrysanthemi Flos), Lianqiao (Forsythiae Fructum).
Wang (63 years old): Pathogen stagnation, lateral headache.
Xianheyebian (Fresh Nelumbinis Petiolus Margin, 3 qian), Kudingcha (Ilicis Kudingchae Folium, 1.5 qian), Lianqiao (Forsythiae Fructum, 1.5 qian), Heishanzhi (Gardeniae Fructum, 1 qian), Manjingzi (Vittariae Spora, 1 qian), Xingren (Armeniacae Semen Amarum, 2 qian), Mutong (Akebiae Caulis, 8 fen), Baizhi (Angelicae Dahuricae Radix, 1 fen).
Yu (50 years old): Wind-stagnation headache.
Xianheye (Fresh Nelumbinis Petiolus), Kudingcha (Ilicis Kudingchae Folium), Danhuangqin (Scutellariae Radix), Heishanzhi (Gardeniae Fructum), Lianqiao (Forsythiae Fructum), Manjingzi (Vittariae Spora), Mutong (Akebiae Caulis), Baizhi (Angelicae Dahuricae Radix).
Certain patient (47 years old): Internal-wind headache, cold tears. (Liver-Wind Syndrome)
Chao Qizi (Frucci Lycii Chinensis Semina), Zhi Shouwu (Polygoni Multiflori Radix Praeparata), Baiziren (Biotae Semen), Fushen (Poria Cum Radix), Chao Juhua Tan (Chrysanthemi Flos Carbonized), Xiaoheidoupi (Phaseoli Vulgaris Cutis Nigra).
Shen's wife: Pain located at the left back of the head. Jue-Yang Wind-Wood qi strikes upward.
Xi Shengdi (Rehmanniae Radix), Sheng Baishao (Paeoniae Radix Alba), Baiziren (Biotae Semen), Chao Qizi (Frucci Lycii Chinensis Semina), Juhua (Chrysanthemi Flos), Fushen (Poria Cum Radix).
Sun (24 years old): Latent summerheat, alternating chills and fever, headache. (Latent Summerheat Syndrome)
Xianheyebian (Fresh Nelumbinis Petiolus Margin), Lianqiao (Forsythiae Fructum), Kudingcha (Ilicis Kudingchae Folium), Xiakucao (Prunellae Spica), Shanzhi (Gardeniae Fructum), Manjingzi (Vittariae Spora), Nongpo (Magnoliae Officinalis Cortex), Mutong (Akebiae Caulis).
Certain patient: Summerheat, dampness, wind, and heat mix in the upper orifices. Body fluids cannot circulate, becoming stagnant, resulting in lateral headache, stiff tongue, and dryness. Treatment should be clearing and dispersing.
Lianqiao (Forsythiae Fructum), Shigao (Gypsum Fibrosum), Sheng Gancao (Glycyrrhizae Radix et Rhizoma), Huashi (Talcum), Manjingzi (Vittariae Spora), Lingyangjiao (Saigae Tataricae Cornu), Hegeng (Nelumbinis Costula), Sangye (Mori Folium).
Mr. Cheng: Knowing that excessive blood loss causes headache due to yin deficiency and yang excess, adding dispersing methods contradicts the previous intent. (Blood Deficiency with Floating Yang)
Fumai Tang (Decoction for Reviving the Pulse) minus Renshen (Ginseng Radix), Shengjiang (Zingiberis Rhizoma Recens), Guizhi (Cinnamomi Ramulus), plus Zuomuli (Ostreae Concha).
Second consultation: The pulse is rapid, deficient, and restless, fully demonstrating severe injury to yin qi and floating of yang qi. Headache with tendon twitching. Continue with sedating and anchoring methods.
Muli (Ostreae Concha), Ejiao (Colla Corii Asini), Renshen (Ginseng Radix), Shengdi (Rehmanniae Radix), Zhigancao (Glycyrrhizae Radix et Rhizoma Praeparata), Baishao (Paeoniae Radix Alba), Tiandong (Asparagi Radix).
Mr. Zhu: It is said that comfort is found in coolness, while warmth inevitably causes headache and tendon twitching. External massage and pinching can relieve it. Generally, Liver-Wind and Yang disturbance imply weakness in the Stomach collaterals. Food intake lacks sweetness, indicating Qi deficiency in the Middle Jiao. Although salty-moist mollusk substances that anchor Yang have achieved efficacy, the description seems vague and speculative, not deep theoretical discourse. For now, decocting as a substitute, discussing sour-sweet methods. Moreover, at fifty-four, one is past mid-life. Long-term intake of heavy-yin herbs may damage vital energy. For half a month, diagnostic efficacy has been lacking; cautiously recognizing this, use Guben Gao (Solidify the Root Paste). (Liver Yang invading Stomach and reversing upward)
Mr. Xu: In the past, lower deficiency was treated effectively with warming Kidney and cooling Liver. Eye disease in spring indicates sudden rising of Yang, a sign of winter failure to store and gather, and Water failing to nourish Wood. Frequently treating eyes with bitter-pungent methods caused Wind-Yang to gather at the vertex, Liver Wood to harass horizontally, and Stomach to be damaged, leading to vomiting. Now the heart feels dry as if burning, the head throbs with dull pain, alternating cold and hot, all indicative of Yin-Yang reversal. Liver is a rigid organ, warm-dryness cannot coexist peacefully. Furthermore, pungent ascending dispersal only worsens the condition; how can we repeat past mistakes? Temporarily focus on calming Liver and benefiting deficiency, hoping for peaceful Yang and extinguished Wind.
Ejiao (Colla Corii Asini), Xiaomai (Tritici Caput Japonici Fructus), Maimai (Ophiopogonis Radix), Sheng Baishao (Paeoniae Radix Alba), Beishashen (Glehniae Radix), Nanzao (Jujubae Fructus).
Second consultation: Sudden cold and heat, vexation, vertex pain. Reversal of Jue-Yang indicates deficiency of Yin fluids. The previous case clarified the inappropriateness of rigid drugs. Daizhe Shi (Haematitum) is sour and heavy, a strong anchoring agent, also a rigid drug. Examining the seven hernias, Zhang Zihe often used pungent-aromatic draining methods, adopting the Tiger-Hide method, showing that the Hernia category also has soft methods. Physicians familiar with established formulas must ponder deeply; otherwise, they merely seek to conform superficially. Now that vomiting has stopped, Yin-nourishing herbs can be temporarily administered, i.e., Water generating Wood method. Propose using the solidified Guben formula, guiding from Yang at dawn. Add Qiushi (Urine Sediment).
Grandma Ye: Evening headache, rising fire with heart discomfort, Wind-Yang冒ting upward, preventing Jue.
Xi Shengdi (Rehmanniae Radix), Ejiao (Colla Corii Asini), Muli (Ostreae Concha), Fushen (Poria Cum Radix), Maimai (Ophiopogonis Radix), Sheng Baishao (Paeoniae Radix Alba).
Mr. Shi: The head resembles Heaven, and by principle, does not accept turbid pathogens. Now, chronic pain presents with protrusion, seemingly due to external pathogens clouding the clear Qi and Blood. However, frequent ingestion of Guifu (Cinnamon Twig and Aconite Root) and Heche (Placenta Human) showed no harm. Considering the upper half of the body belongs to Yang, and the head is Yang within Yang. Generally, when Yang Qi is first deficient, clear pathogens enter upward, causing Qi and Blood stasis and obstruction, leading to persistent pain. The method should be to promote circulation of Clear Yang, avoiding surface-dispersing. Using moxibustion according to method is one rationale. (Jueyin Qi and Blood Obstruction by Pathogens)
Shu Banxia (Pinelliae Rhizoma Praeparatum), Bei Xixin (Asari Radix et Rhizoma), Pao Chuanwu (Aconiti Radix Preparata), Zhi Quanxie (Scorpio), Jiangzhi (Zingiberis Rhizoma Recens Juice).
Second consultation: Yang Qi is obstructed by pathogens, clear orifices are not unblocked. Examining Zhou Li, toxic drugs are collected to attack disease, borrowing insects and ants to search and eliminate in the blood to attack pathogenic knots, an ancient method neglected by physicians. Now pain spreads to the back of the head, nausea and vomiting below the heart, signs of Jueyin. Chronic illness leads to deficiency; attacking pathogens must simultaneously support healthy Qi.
Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Banxia (Pinelliae Rhizoma), Jiangzhi (Zingiberis Rhizoma Recens Juice), Zhi Quanxie (Scorpio), Fengfang (Vespa Nidus).
Zhang (22 years old): Taiyang headache, connecting to zygomatic bone, behind ear, and gums. Unresolved from summer solstice to Frost Descent, latent pathogen unresolved. Treat Yangming and Shaoyang. (Latent Pathogen in Gallbladder and Stomach)
Lianqiao (Forsythiae Fructum), Lingyangjiao (Saigae Tataricae Cornu), Niubangzi (Arctii Fructus), Gegen (Puerariae Lobatae Radix), Chishao (Paeoniae Radix Rubra), Baizhi (Angelicae Dahuricae Radix), Xianjuye (Chrysanthemi Indici Folium).
The head is the meeting point of all Yang meridians, converging with the Jueyin Liver meridian at the vertex. Yin-Cold pathogens cannot ascend because Yang Qi is blocked, allowing turbid pathogens to occupy the upper region. Jueyin Wind-Fire can then reverse upward causing pain. Thus, the symptom of headache is always caused by failure of Clear Yang to ascend, with Fire and Wind taking advantage of deficiency to enter upward. Observing Mr.'s treatment methods for headache, they do not exceed this principle. For headache due to Yang deficiency, turbid pathogen blockage, and Qi-Blood stasis, use insects and ants to search collaterals, primarily promoting Yang circulation. For headache due to Fire-Wind changes and Summer-Wind pathogen stagnation, use fresh Lotus Leaf, Kuding Tea, Vitex, Gardenia, etc., primarily pungent dispersal and light clearing. For headache due to Yin deficiency and Yang hyperactivity, use Zhang Zhongjing's Fumai Tang and Ganmai Dazao method, adding Ejiao, Baishao, Muli, primarily sedating, benefiting deficiency, harmonizing Yang, and extinguishing Wind. For headache due to Jue-Yang Wind-Wood striking upward combined with internal Wind, use Shouwu, Baoren, Doupi, Ganju, Shengshao, Qizi, etc., primarily extinguishing Liver Wind and nourishing Kidney fluids. Analyzing one symptom so meticulously and clearly, it can be said that technique and understanding are both attained. (Commentary by Zou Shicheng)
Xu's Commentary: Headwind syndrome often has Heat as the root and Cold as the branch. The cases mostly use fire-clearing herbs, which can indeed cure mild Wind-Fire cases. However, if Cold pathogen invades the brain, or Wind-Cold binds externally, warming and dispersing methods must not be omitted. Furthermore, lifting methods deserve extensive study.