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The head is the convergence point of all Yang meridians. When clear Yang fails to ascend, pathogenic factors take advantage of this deficiency, leading to headache. However, there are distinctions between internal injury and external contraction: for external contraction of wind-cold, dispersing methods are appropriate; when heat pathogens transmit to the stomach fu-organ and heat qi attacks upward, clearing methods are appropriate; for cold pathogens directly striking the yin meridians with cold qi forcing upward, warming methods are appropriate. Detailed treatment methods are described in the Shanghan (Cold Damage) section, so they are not repeated here. Besides standard wind-cold headaches, there are also conditions such as hemi-cephalgia (Pian Tou Feng), thunder-headache (Lei Tou Feng), guest-cold invading the brain, stomach fire rushing upward, phlegm-jue headache, epidemic big-head disease (Da Tou Tian Xing), traumatic wind-stroke (Po Nao Shang Feng), pain in the supraorbital ridge, and orbital pain. Furthermore, there is true headache (Zhen Tou Tong), which can be fatal from morning to evening, representing an even more critical condition. All these must be carefully differentiated.

Hemi-cephalgia presents as pain on one side of the head and is divided into wind-heat and blood-deficiency types. In the wind-heat type, there may be twitching of tendons and vessels, nasal congestion, or frequent discharge of turbid nasal mucus; it is treated primarily with Kongqing Gao (Clearing Empty Paste). In the blood-deficiency type, pain is lighter during the day and heavier at night, radiating to the corner of the eye; it is treated primarily with Xiaoyao San (Free and Easy Wanderer Powder). Thunder-headache presents with headache accompanied by nodules on the scalp or a sensation of thunder rumbling within the head; it mostly belongs to phlegm-fire and is treated primarily with Qingzhen Tang (Clearing and Shaking Decoction). Guest-cold invading the brain presents with brain pain radiating to the teeth, coldness of the hands and feet, and cold breath from the mouth and nose; it is treated primarily with Qianghuo Fuzi Tang (Notopterygium and Aconite Decoction). Stomach fire rushing upward presents with a surging-large pulse, thirst with desire for cold drinks, and distended, rigid temporal arteries; it is treated primarily with Jiawei Shengma Tang (Modified Cimicifuga Decoction). Phlegm-jue headache presents with excessive phlegm in the chest and diaphragm, and dizziness upon movement; it is treated primarily with Banxia Baizhu Tianma Tang (Pinellia, Atractylodes Macrocephala, and Gastrodia Decoction). Kidney-jue headache presents with heaviness of the head and floating sensation of the feet, along with soreness and weakness of the waist and knees; this corresponds to the classic description of "deficiency below and excess above." When kidney qi declines, the lower part becomes deficient, and floating fire rises upward, causing upper excess. Specifically, if there is deficiency of true water (Kidney Yin), the pulse will be rapid and forceless; if there is deficiency of true fire (Kidney Yang), the pulse will be large and forceless. For true water deficiency, Liuwei Wan (Six-Ingredient Pill with Rehmannia) is used; for true fire deficiency, Bawei Wan (Eight-Ingredient Pill with Rehmannia) is used. Epidemic big-head disease presents with massive swelling of the head, sometimes as large as a measuring cup; it is a type of epidemic disease. The mild form is called Fayi (Jaw Swelling), with swelling around the ears, caused by stagnant fire; it is treated primarily with Puji Xiaodu Yin (Universal Benefit Decoction to Eliminate Toxins), supplemented by acupuncture or bian stone therapy. Traumatic wind-stroke occurs when wind pathogen enters through a wound, presenting mainly with convulsions; it is treated primarily with Fangfeng San (Saposhnikovia Powder). Pain in the supraorbital ridge or orbital region belongs to the Liver meridian. Headache triggered by light exposure belongs to blood deficiency and is treated with Xiaoyao San. Severe pain preventing eye opening belongs to wind-heat and is treated with Kongqing Gao. True headache mostly belongs to yang decline. The head governs all Yang meridians, and the brain is the sea of marrow, unable to withstand pathogenic invasion. If yang qi is severely deficient and the brain is invaded by pathogens, true headache occurs, characterized by cyanosis of the hands and feet extending to the joints, a condition difficult to save. At this stage, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) should be administered rapidly, added with Chuanminzhizi (Vitex Fruit), Chuanxiong (Ligusticum Rhizome), and Fuzi (Aconite Root), while simultaneously administering Bawei Wan. Occasionally, survival is possible; this must not be neglected.