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Xiaoyao San (Free and Easy Wanderer Powder) combined with Chuanxiong Rhizome (Rhizoma Chuanxiong) and Baizhu Flower (Flos Chrysanthemi Indici) yields good results for headache. For blood deficiency headache, if various medicines are ineffective, Danggui Buxue Tang (Decoction for Tonifying Blood) with Deer Antler (Cornu Cervi Pantotrichum) can be used (because deer antler grows on the head, it shares the same qi with the human head). For kidney meridian depletion headache, Zuogui Yin (Left Restoration Decoction) is used; for severe pain where yang qi is about to collapse, Wuzhuyu Tang (Evodia Decoction) can be used to salvage the dying yang (this method can only save one or two out of ten patients.

(When this condition proves unresponsive to all medicines, contemporary physicians merely adhere to the inherited theories in medical texts and commonly used formulas of the time, which certainly cannot cure such a serious illness. Herein is recorded Gao Shizong's groundbreaking insight, to bolster the courage of colleagues, as a plan of burning one's bridges.

There are three types of headache syndromes: one is Taiyang headache; one is Shaoyang headache; and one is Jueyin headache. The Taiyang meridian ascends to the forehead, intersects at the vertex, and connects with the brain. Above Taiyang, cold qi governs; thus, Taiyang headache is caused by cold. The Shaoyang meridian ascends to reach the temporal angle. Above Shaoyang, ministerial fire governs; thus, Shaoyang headache is caused by fire. The Jueyin meridian emerges from the forehead and meets the Du meridian at the vertex. Above Jueyin, wind qi governs; thus, Jueyin headache is caused by wind. Although headaches differ in being cold, fire, or wind, one must observe their severity and distinguish yin and yang. When headache occurs alongside other bodily diseases, the pain is mild. When headache occurs alone, causing pain so severe as to feel like death, the pain is severe. Whenever yin blood is deficient and yang heat is excessive, the pain is mild; conversely, when yang qi is deficient and yin cold is excessive, the pain is severe. For wind-fire headache, if it is an excess condition, clear and disperse it; if it is a deficiency condition, tonify and nourish it. Yin-cold headache is due to yin excess and yang deficiency, known as yang-deficient headache, which cannot be treated without Ginseng Radix et Rhizoma (Ren Shen), Cinnamon Bark (Rou Gui), and Aconite Lateralis Radix Praeparata (Fu Zi). In the world, upon encountering headache, people often assume it is due to external wind-cold and immediately administer dispersing treatments. If dispersing fails, cooling herbs are gradually added: either Chuanxiong Rhizome (Chuan Xiong), Saposhnikovia Root (Fang Feng), Schizonepeta Spike (Jing Jie), or Notopterygium Rhizome et Radix (Qiang Huo); or Scutellaria Root (Huang Qin), Coptis Rhizome (Huang Lian), Gardenia Fruit (Zhi Zi), or Gypsum Fibrosum (Shi Gao). If wind-fire headache encounters these, the body may not be harmed; but if yang-deficient headache encounters them, death is certain. Can one not be cautious!

The world holds the theory that "the three yin meridians do not suffer headache," but how could they know that yang-deficient headache is purely yin-cold, with yang nearly extinguished? Those suffering from this have less than one survivor in ten. The reason is akin to the sun not clinging to the sky but sinking into the sea, causing all directions to collapse. Man corresponds to heaven and earth: Heaven has the sun, and man also has the sun; the Yang of Ministerial Fire is the sun. Earth has the four seas, and man also has the four seas: the head is the Sea of Marrow, the chest is the Sea of Qi, the stomach is the Sea of Grain, and the uterus/abdomen is the Sea of Blood. The sun in heaven travels through the sky by day and the sea by night; the sun in man travels through the sky and also through the sea. From the neck to the tailbone is like the sun traveling through the sky; from the Sea of Blood to the Sea of Marrow is like the sun traveling through the sea. Now, yang-deficient headache is caused by yin-cold obscuring the sun, rebelling within the Sea of Marrow, unable to ascend to the vertex and neck to travel along the back. Instead, it enters yin from yang and travels through the abdomen. Therefore, unremitting headache leads to vexation; vexation indicates sunlight rebelling in the Sea of Qi. Unremitting vexation leads to vomiting; vomiting indicates sunlight rebelling in the Sea of Grain. Unremitting vomiting leads to coma; coma indicates sunlight rebelling in the Sea of Blood. Headache progressing to coma signifies entering the extreme of yin, like the sun sinking to the bottom of the sea. If treated correctly, this condition might save two or three out of a hundred, but shallow physicians, recklessly prescribing decoctions, fail in treatment. Some claim liver wind enters the brain, some claim hostile qi invades the brain, some call it true headache. Despite such statements, dispersing wind and cold herbs are inevitably used. How could they know that dispersing methods are not for treating this, but rather harm the patient? The *Lingshu · Si Hai Lun* states: "Those who obtain harmony live; those who obtain rebellion perish; those who know how to regulate benefit; those who do not know how to regulate are harmed." This refers precisely to headache where the sun rebels in the sea, yet physicians act contrary to nature, failing to treat properly and causing death.

My commentary: Gao Shizong's discussion reveals what predecessors had not yet expounded, but I regret that there is discussion without formula. The statement "non-Ginseng, Cinnamon, and Aconitate cannot treat it" is superficial and not worthy of esteem. I propose using Bitong Tang (White Pass Decoction) with doubled Aconite Lateralis Radix Praeparata (Fu Zi) as the precise formula. Since yang qi originates in the lower jiao, the妙 (wonder) lies in heavily using the pungent and hot nature of Fu Zi to stimulate it from below, Ganjiang (Dried Ginger) to connect it from the middle, and Congbai (Scallion White) to open it from above. This can save one or two out of ten.

Vertigo (Xuan Yun) refers to dizziness and spinning instability. The *Suwen · Zhi Da Yao Lun* says: "All wind-induced tremors and vertigo belong to the Liver." This refers to excess conditions, suitable for Erchen Tang (Two-Cured Decoction) plus Saposhnikovia Root (Fang Feng), Polygonatum Odoratum Rhizome (Yuzhu), Chuanxiong Rhizome (Chuan Xiong), Gastrodia Tuber (Tian Ma), Atractylodes Macrocephala Rhizome (Baizhu), and Uncaria Ramulus cum Uncis (Gouteng). If due to phlegm-fluid retention, double the Pinellia Tuber (Banxia) and add Alisma Rhizome (Zexie) in double amount. If fire is excessive, add Scutellaria Root (Huang Qin) and Scrophularia Root (Yuanshen). The *Lingshu · Wei Qi Pian* says: "Upper deficiency causes vertigo." This refers to deficiency conditions, suitable for adding Ginseng Radix et Rhizoma (Renshen) and [Licorice Root (Gancao)]; if deficiency is severe, add Aconite Lateralis Radix Praeparata (Fu Zi). The *Lingshu · Hai Lun* says: "Deficiency of the Sea of Marrow leads to spinning head, tinnitus, soreness of shins, vertigo, blindness, lassitude, and desire to lie down." This indicates pathology located upward but rooted downward, suitable for adding Cistanche Stem (Rou Cong Rong), Aconite Lateralis Radix Praeparata (Fu Zi), and Morinda Officinalis Root (Bajitian). If extremely deficient and various medicines fail, use One liang of Deer Antler (Lurong), decocted in wine, with one li of Musk (Shexiang) taken orally. This aligns with the *Lingshu · Jing Mai Pian*: "When the Du meridian is excess, the spine is stiff; when deficient, the head feels heavy and sways." Additionally, there are cases of overwhelming fire causing unbearable vertigo, treated with Rhubarb Rhizome (Dahuang) stir-fried three times in wine, ground to powder, and taken with tea infusion. This condition, along with headache, is not exclusively a exterior syndrome, because the head is the convergence of all yang meridians, and yang governs the exterior; thus, it is listed under exterior syndromes.

(Explanation of Classics) The *Suwen · Mai Yao Jing Wei Lun* states: "Floating and scattered pulse indicates falling." 'Pu' (fall) is synonymous with 'Shun'. The *Records of the Grand Historian · Biography of Xiang Yu* quotes: "Glaring eyes." Meaning causing eye movement. Falling face-up is called Jiang (stiff/rigid), falling face-down is called Pu (collapse/fall), which refers to sudden collapse due to wind-deficiency vertigo. The *Lingshu · Kou Kai Pian* states: "Insufficiency of upper qi leads to insufficient filling of the brain, bitter ringing in the ears, painful tilting of the head, and dizzy eyes." The *Lingshu · Jing Mai Pian* states: "When the qi of all five yin meridians is exhausted, the optic nerves twist; twisting causes eye spinning. Eye spinning means the spirit dies first; if the spirit dies first, death occurs in one and a half days."