治春温夏热之病,其症发热头痛,与正伤寒同,但不恶寒而口渴,与正伤
柴胡(一钱二分) 葛根(一钱五分) 赤芍(一钱) 甘草(五分) 黄芩(一钱五分) 知母(一钱) 贝母
(一钱) 生地(二钱) 丹皮(一钱五分
水煎服。
心烦,加淡竹叶十片;谵语,加石膏三钱。
问曰∶头痛何以是太阳证?答曰∶三阳经上至于头,皆有头痛,惟太阳经脉最长,其痛
居多,故头痛为表证。又问曰∶三阳头痛有别乎?答曰∶太阳之脉,从巅入络脑,还出别下
项,循肩膊,由夹脊抵腰中。故太阳头痛,头脑痛而连项脊也。阳明之脉,起于鼻,络于目
交额中。凡阳明头痛,头额痛而连面目也。少阳之脉,起于目锐 ,下耳后。凡少阳
头痛,耳前后痛而上连头角也。以此为别。又问曰∶三阴本无头痛,今见直中证,亦有头痛
何也?答曰∶此直中而兼外感也。又问曰∶伤寒传经至厥阴,亦有头痛,何也?答曰∶厥阴证
头痛脉浮,是里邪达表,欲得汗解也,宜微表之。又问曰∶阳明腑病,口渴便闭,亦有头
痛何也?答曰∶阳明之经络于头目,因其腑热熏蒸,上攻于头目之间,以致头痛。夫经病可
以传腑,腑病亦可以连经,此相因之至理。然必有其实有腑证,方可用白虎清之。若在恶寒发
热初起之时,则为外感风寒,不得与阳明腑病同类混称也。
To treat diseases of spring-warmth and summer-heat, the symptoms include fever and headache, which are similar to typical Shanghan (Cold Damage), but without aversion to cold and with thirst.
Chaihu (1 qian 2 fen) [Bupleuri Radix], Gegen (1 qian 5 fen) [Puerariae Radix], Chishao (1 qian) [Paeoniae Radix Rubra], Gancao (5 fen) [Glycyrrhizae Radix et Rhizoma], Huangqin (1 qian 5 fen) [Scutellariae Radix], Zhimu (1 qian) [Anemarrhenae Rhizoma], Beimu (1 qian) [Fritillariae Bulbus], Shengdi (2 qian) [Rehmanniae Radix], Danpi (1 qian 5 fen) [Moutan Cortex].
Decoct in water and take orally.
If there is vexation, add ten slices of Danzhuye (Lophatheri Herba); if there is delirium, add 3 qian of Shigao (Gypsum Fibrosum).
Question: Why is headache considered a Taiyang disease (disease pattern caused by pathogenic factors invading the Taiyang channel)? Answer: The three Yang channels all ascend to the head and can cause headache. However, the Taiyang channel is the longest, so headaches are mostly due to Taiyang involvement; thus, headache is regarded as a exterior syndrome. Another question: Is there a distinction in headache among the three Yang channels? Answer: The Taiyang channel starts from the vertex, enters the brain, emerges again, descends separately behind the neck, follows the shoulder blades, and reaches the middle of the waist from the paravertebral region. Therefore, Taiyang headache involves pain in the head that radiates to the nape and spine. The Yangming channel originates at the side of the nose, connects with the eyes, and meets at the forehead. Consequently, Yangming headache involves pain in the forehead that radiates to the face and eyes. The Shaoyang channel originates at the outer canthus and descends behind the ear. Thus, Shaoyang headache involves pain around the ears that extends upward to the temporal angle. These features serve as distinctions. Another question: The three Yin channels normally do not present with headache. Now, in cases of direct invasion (pathogen directly entering the zang-fu organs), headache also occurs. Why is this? Answer: This is due to direct invasion accompanied by external contraction. Another question: When Shanghan transmits to the Jueyin channel, headache also occurs. Why? Answer: In Jueyin syndrome, headache with a floating pulse indicates interior pathogens reaching the exterior, seeking resolution through sweating; therefore, a mild diaphoretic method should be used. Another question: In Yangming fu-organ disease, with thirst and constipation, headache also occurs. Why? Answer: The Yangming channels connect with the head and eyes. Due to the steaming effect of heat in the fu-organs, it attacks upward to the head and eyes, causing headache. Exterior channel diseases can transmit to the fu-organs, and fu-organ diseases can also affect the channels; this is the fundamental principle of their interconnection. However, only when there are definite fu-organ signs should Baihu Tang (White Tiger Decoction) be used to clear the heat. If these symptoms occur during the initial stage of aversion to cold and fever, it is an external contraction of wind-cold and should not be confused with Yangming fu-organ disease.