头痛而起核块者，是也。
〔子和〕凡雷头懒于俗呼之，谬名也。可用茶调散吐之，次用神芎丸下之，然后服乌荆丸及愈风
饼子之类。衰者，可用凉膈散消风散热。
茶调散方（见上下部，即二仙散是也。）
神芎丸
大黄 黄芩（各二两） 牵牛 滑石（各四两）
上为细末，滴水为丸，如小豆大，温水下十五丸，每服加十丸，以利为度，日三服。
愈风饼子
川乌（炮，半两） 川芎 甘菊 白芷 防风 细辛 天麻 羌活 荆芥 薄荷 甘草（炙。以上各一两）
上为细末，水浸蒸饼为剂，捏作饼子。每服三五饼，细嚼茶酒送下，不计时候。
凉膈散（方见前寒热条。）
〔《保》〕夫治雷头风者，诸药不效，为与证不相对也。盖雷头风者，震卦主之，震仰盂，
故予制药内加荷叶者，象震之形，其色又青，乃述类象形，当煎《局方》中升麻汤主之。
升麻汤治头面疙瘩，憎寒拘急，发热，状如伤寒，
升麻 苍术 荷叶
上为细末，每服五钱，水一盏，煎七分，温服，食前后。或烧全荷叶一个，研细调药，服之妙。
〔子和〕雷头风者，是头上有赤肿结核，或如酸枣状，可用 针出血则愈矣。
〔《素》〕雷头风∶上囟 百会 风池。
头痛如肿，大如斗是也，大率多是天行时疫病。
〔垣〕泰和年，东垣以监纳济源税，时长夏多疫疠，初觉憎寒体重，次传面目肿盛，目不能
开，上喘，咽喉不利，舌干口燥，俗云大头天行。亲戚不相访问，如染之多不救。张县丞亦得此证，至
五六日，医以承气汤加蓝根下之，稍缓，翌日其病如故，下之又缓，终莫能愈，渐至危笃。或曰李明之
存心于医，可以请治，遂命诊视，具说其由曰∶夫身半以上，天之气也；身半以下，地之气也。
此虽邪热客于心肺之间，上攻头而为肿盛，以承气下之，泻胃中之实热，是诛罚无过，殊不知适其
病所为故。遂处方用黄连、黄芩，味苦寒，泻心肺间热以为君。橘红、玄参苦寒，生甘草甘寒，泻
火补气以为臣。连翘、鼠粘子、薄荷叶苦辛平，板蓝根味甘寒，马屁勃、白僵蚕味苦平，散肿
消毒定喘以为佐。新升麻、柴胡苦平，行少阳阳明二经不得伸，桔梗味辛温，为舟楫不令下行。共为细
末，用汤调，时时服之，拌蜜为丸，噙化之，服尽良愈。因叹曰∶往者不可追，来者尤可及。凡
他所有是病者，皆书方以帖之，全治甚众。
普济消毒饮子
黄芩 黄连（各半两） 人参（三钱） 橘红 玄参 甘草（生。各二钱） 连翘 鼠粘子 板蓝根
马屁勃（各一钱） 白僵蚕（炒，七分） 升麻（七分） 柴胡 桔梗（各二钱）
上为细末，服如前法，或加防风、薄荷、川芎、当归身， 咀如麻豆大。每服五钱，水煎去
渣，热服之，食后时时服之。如大便硬，加酒煨大黄一钱，或二钱，以利之。肿热甚者，宜砭刺
之。
〔海〕大头病者，虽在身半以上，热伏于经，以感天地四时非节瘟疫之气所着，以成此疾。至于
溃裂脓出，而又染他人，所以谓之疫疠也。大抵足阳明邪热太甚，实资少阳相火为之炽，多在少阳，
或在阳明，甚则逆传。视其肿势在何部分，随其经而取之，湿热为肿，木盛为痛，此邪发于首，
多在两耳前后，所先见出者，为主为
根，治之宜早，药不宜速，恐过其病。所谓上热未除，中寒已作，有伤人命矣。此疾是自外而
之内者，是为血病，况头部分受邪，见于无形之处，至高之分，当先缓而后急。先缓者，谓邪气在上，
着无形之部分，既着无形，所传无定，若用重剂大泻之，则其邪不去，反过其病矣。虽用缓药，若
又急服之，或食前，或顿服，咸失缓体，则药不能除病矣。当徐徐渍无形之邪，或药性味形体
据象服饵，皆须不离缓体及寒药，或酒炒浸之类皆是也。后急者，谓前缓剂已经高分，泻邪气入于中，
是到阴部，染于有形质之所，若不速去，反损阴也。此却为客邪，当急去之，是治客以急也。且治
主当缓者，谓阳邪在上，阴邪在下，各为本家病也。若急治之，不惟不能解其纷，而反致其乱矣，
此所以治主当缓也。治客当急者，谓阳分受阳邪，阴分受阴邪，主也。阴分受阳邪，阳分受阴邪，
客也。凡所谓客者当急去之，此治急以客也。假令少阳阳明之为病，少阳为邪者，出于耳前后也。
阳明者，首面大肿也。先以黄芩、黄连、甘草，通炒过，锉煎少少不住服呷之，或服毕，再用大
黄或酒浸或煨，又以鼠粘子新瓦上炒香， 咀煎去渣，纳芒硝各等分，亦细细呷之。当食后用，
徐得微利。及邪气已，只服前药。如不已，再服后药，根据前次第用之，取大便利，邪已即止。如
阳明渴者，加石膏。少阳渴者，加栝蒌根汤。阳明行经，加升麻、葛根、芍药之类。太阳行经，
加羌活、防风、荆芥之类。选而加之，并与上药均合，不可独用散也。
〔洁〕黑白散治大头病如神。
乌黑蛇（酒浸） 白花蛇（去头尾，酒浸） 雄黄（二钱） 大黄（煨，半两）
上为极细末，每服一二钱，白汤调无时。
〔海〕疫毒头肿者，甘桔汤加鼠粘子、大黄、芒硝。
〔丹〕大头天行病。
羌活 酒芩 酒蒸大黄
〔《素》〕巨阳之厥，则肿首头重。（全文见厥。）
〔《山》〕大头风，用井底泥调大黄、芒硝涂之。（此方若在表者忌之，在里者宜之。）
运气 大头病皆属火，盖经所谓上肿者，即其属也。经云∶少阳司天之政，风热参布，太阴
横流，寒乃时至，民病上，怫肿色变。又云∶少阴司天之政，热病生于上，清病生于下，民病
嗌干肿上，终之气燥令行，余火内格，肿于上咳喘。其治方，东垣普济消毒饮子得之矣。
Headache accompanied by the formation of nodules or lumps is referred to as Lei Tou Feng (Thunderhead Wind).
[Liu Wansu (Zihe)] The term "Lei Tou Feng" is a common vulgar misnomer and an erroneous name. It can be treated with Cha Tiao San (Tea-Regulating Powder) to induce vomiting, followed by Shen Xiong Wan (Divine Skull Pill) to purge downward, and then administered Wu Jing Wan (Blackthorn-Perilla Pill) and Yu Feng Bing Zi (Wind-Resolving Cakes), among others. For those with deficient constitution, Liang Ge San (Cooling the Diaphragm Powder) can be used to dissipate wind and clear heat.
Cha Tiao San Formula (See Upper Part Diseases, which is identical to Er Xian San.)
Shen Xiong Wan
Da Huang (Rhubarb Root and Rhizome), Huang Qin (Scutellaria Root) (each 2 liang); Qian Niu (Morning Glory Seed), Hua Shi (Talcum) (each 4 liang).
Grind the above into fine powder, add water drop by drop to form pills the size of small beans. Take 15 pills with warm water, increasing by 10 pills per dose until bowel movement is achieved. Take three times daily.
Yu Feng Bing Zi
Chuan Wu (Prepared Aconite Lateral Root), Chuan Xiong (Ligusticum Rhizome), Gan Ju (Chrysanthemum Flower), Bai Zhi (Angelica Dahurica Root), Fang Feng (Saposhnikovia Root), Xi Xin (Asarum Root), Tian Ma (Gastrodia Rhizome), Qiang Huo (Notopterygium Rhizome), Jing Jie (Schizonepeta Spike), Bo He (Mint Herb), Gan Cao (Licorice Root, honey-fried) (each 1 liang).
Grind the above into fine powder. Use steamed wheat cake soaked in water as a binder, shape into cakes. Chew 3–5 cakes thoroughly each time, swallow with tea or wine, at any time.
Liang Ge San (Formula see preceding section on Cold and Heat.)
[Bao Ming Ji] When treating Lei Tou Feng, if various medicines are ineffective, it is because the medicine does not correspond to the syndrome. Lei Tou Feng is governed by the Zhen Trigram. The Zhen trigram resembles an inverted bowl (Yang above, Yin below). Therefore, when I formulate medicines, I add He Ye (Lotus Leaf) to symbolize the shape of Zhen; its color is green, following the principle of "describing categories by image." One should decoct and take Sheng Ma Tang (Cimicifuga Decoction) from the *Ju Fang* (Standard Formulas of the Imperial Medical Bureau) as the primary treatment.
Sheng Ma Tang treats head and facial nodules, aversion to cold with stiffness, fever, resembling Tai Yang disease.
Sheng Ma (Cimicifuga Rhizome), Cang Zhu (Atractylodes Rhizome), He Ye (Lotus Leaf).
Grind the above into fine powder. Take 5 qian each time with one cup of water, decoct to 70%, take warm, before or after meals. Alternatively, burn one whole lotus leaf, grind finely, and mix with the medicine for ingestion, which yields excellent results.
[Liu Wansu (Zihe)] Lei Tou Feng refers to red swelling and tubercles on the head, or lumps the size of a sour jujube. Pricking them with a needle to bleed will result in cure.
[*Su Wen*] Lei Tou Feng: Acupoints Shang Xin, Bai Hui, Feng Chi.
Headache with swelling so large that the head resembles a dou (a unit of volume), generally belongs to Tian Xing Shi Yi Bing (Epidemic diseases spreading through the air).
[Li Gao (Dongyuan)] During the Taihe era, Dongyuan served as the tax supervisor in Jiyuan. In the long summer, many epidemic diseases occurred. Initially, there was aversion to cold and heavy body sensation, followed by severe swelling of the face and eyes, inability to open the eyes, upward panting, throat obstruction, dry tongue, and dry mouth. This is commonly called Da Tou Tian Xing (Big Head Epidemic). Relatives avoided visiting each other; once infected, most could not be saved. Magistrate Zhang also contracted this disease. By the fifth or sixth day, physicians used Cheng Qi Tang (Order the Qi Decoction) plus Lan Gen (Isatis Root) to purge, which provided slight relief. The next day, the condition remained unchanged. After purging again, it slightly eased, but ultimately failed to cure, progressing to a critical state. Someone suggested that Li Mingzhi (Li Gao) devoted himself to medicine and could be consulted for treatment. Upon examination, he explained the etiology thus: The upper half of the body is governed by Heaven's Qi; the lower half by Earth's Qi. Although pathogenic heat lodges between the Heart and Lung, attacking the head causing severe swelling, using Cheng Qi Tang to purge clears excess heat from the Stomach. This punishes the innocent part. One must treat according to the location of the disease. Thus, he prescribed Huang Lian (Coptis Rhizome) and Huang Qin (Scutellaria Root), bitter and cold, to clear heat from the Heart and Lung as Sovereign herbs. Ju Hong (Tangerine Peel) and Xuan Shen (Scrophularia Root), bitter and cold, along with Sheng Gan Cao (Raw Licorice Root), sweet and cold, to clear fire and tonify Qi as Minister herbs. Lian Qiao (Forsythia Fruit), Shu Niu Zi (Burdock Fruit), Bo He Ye (Mint Leaf), Ban Lan Gen (Isatis Root), Ma Pi Bo (Plantago Seed), and Bai Jiang Can (Silkworm), bitter and pungent/neutral, to dissipate swelling, detoxify, and calm asthma as Assistant herbs. Xin Sheng Ma (Cimicifuga Rhizome) and Chai Hu (Bupleurum Root), bitter and neutral, to unblock the Shaoyang and Yangming meridians where Qi stagnates; Jie Geng (Platycodon Root), acrid and warm, acting as a boat and oar to prevent downward descent. Grind all into fine powder, mix with decoction, take frequently. Mix with honey to make pills, hold in mouth to dissolve. Upon finishing the course, the patient recovered. He sighed, saying: The past cannot be retrieved, but the future can be grasped. For all others suffering from this disease, I wrote down the formula and posted it, curing many.
Pu Ji Xiao Du Yin Zi (Universal Benefit Detoxifying Decoction)
Huang Qin (Scutellaria Root), Huang Lian (Coptis Rhizome) (each 0.5 liang); Ren Shen (Ginseng Root) (3 qian); Ju Hong (Tangerine Peel), Xuan Shen (Scrophularia Root), Gan Cao (Licorice Root, raw) (each 2 qian); Lian Qiao (Forsythia Fruit), Shu Niu Zi (Burdock Fruit), Ban Lan Gen (Isatis Root), Ma Pi Bo (Plantago Seed) (each 1 qian); Bai Jiang Can (Silkworm, stir-fried) (0.7 fen); Sheng Ma (Cimicifuga Rhizome) (0.7 fen); Chai Hu (Bupleurum Root), Jie Geng (Platycodon Root) (each 2 qian).
Grind the above into fine powder. Administer as described previously. Alternatively, add Fang Feng (Saposhnikovia Root), Bo He (Mint Herb), Chuan Xiong (Ligusticum Rhizome), Dang Gui Shen (Angelica Sinensis Root tip), cut into pieces the size of hemp seeds. Take 5 qian each time, decoct in water, strain, take hot, frequently after meals. If stool is hard, add Jiu Wei Da Huang (Wine-processed Rhubarb Root) 1 or 2 qian to promote bowel movement. For severe swelling and heat, bloodletting with bi stones is appropriate.
[Zhu Zhenheng (Haizang)] Da Tou Bing (Big Head Disease), although located in the upper half of the body, involves heat lurking in the meridians, caused by contracting epidemic Qi from the four seasons that deviates from normal climatic patterns. When it ulcerates and discharges pus, it infects others, hence termed Yi Li (Epidemic Pestilence). Generally, excessive pathogenic heat in the Foot-Yangming Meridian relies on the Minister Fire of Shaoyang to become blazing. The disease mostly affects the Shaoyang or Yangming meridians, and in severe cases, transmits reversely. Observe which part shows swelling, and treat according to the affected meridian. Damp-heat causes swelling; Wood excess causes pain. This pathogen originates in the head, mostly around the ears. The initially appearing site is the root and main symptom. Treatment should be early, and medication should not be too aggressive, lest it exceed the pathology. If upper heat is not cleared while middle cold arises, it harms life. This disease enters from outside to inside, involving Blood. Since the head is the highest part and receives pathogen in formless regions, treatment should start slowly and then become urgent. Starting slowly means the pathogen is high and formless; transmission is不定 (uncertain). Using heavy purgatives will fail to remove the pathogen and instead damage healthy Qi. Even with mild drugs, if taken urgently, before meals, or in one dose, the slow nature is lost, and the drug cannot cure. One must slowly steep out the formless pathogen. Drug properties, flavors, forms, and administration methods must adhere to slowness and coldness, such as wine-processing or soaking. Becoming urgent later means the previous mild agents have moved pathogens from high to middle, reaching Yin parts and tangible organs. If not removed quickly, Yin is damaged. This becomes a guest pathogen and must be removed urgently; this is treating guests with urgency. Treating the host (main disease) requires slowness: Yang pathogen above, Yin pathogen below, each being their own home disease. Urgent treatment fails to resolve chaos and creates disorder. Hence, treating the host requires slowness. Treating the guest requires urgency: Yang part receiving Yang pathogen, Yin part receiving Yin pathogen is the host. Yin part receiving Yang pathogen, Yang part receiving Yin pathogen is the guest. Guest pathogens must be removed urgently; this is treating urgency for guests. For example, in Shaoyang-Yangming disease: Shaoyang pathogen manifests around ears. Yangming pathogen manifests as big head swelling. First use Huang Qin, Huang Lian, Gan Cao, stir-fried together, cut, decoct, and sip frequently in small amounts. After finishing, use Da Huang (wine-soaked or roasted), stir-fry Shu Niu Zi on a new tile until fragrant, cut, decoct, strain, add Mang Xiao (Mirabilite) in equal parts, and sip slowly. Take after meals, aiming for mild diarrhea. Once pathogen is gone, take only the first medicine. If not cured, take the second medicine, following the sequence, aiming for thorough bowel movement, stopping when pathogen is cleared. If Yangming meridian thirst occurs, add Shi Gao (Gypsum). If Shaoyang meridian thirst occurs, add Gua Lou Gen (Trichosanthes Root) decoction. For Yangming meridian channel involvement, add Sheng Ma, Ge Gen (Kudzu Root), Shao Yao (Peony Root). For Taiyang meridian channel involvement, add Qiang Huo, Fang Feng, Jing Jie. Select and add these, mixing evenly with the main formula; do not use alone as a powder.
[Zhang Congzheng (Jiegu)] Hei Bai San (Black and White Powder) treats Da Tou Bing miraculously.
Wu Hei She (Dark Black Snake, wine-soaked), Bai Hua She (Banded Krait, remove head and tail, wine-soaked), Xiong Huang (Realgar) (2 qian), Da Huang (Rhubarb Root, roasted) (0.5 liang).
Grind into extremely fine powder. Take 1–2 qian each time, mixed with white boiled water, at any time.
[Zhu Zhenheng (Haizang)] For Yi Du Tou Zhong (Epidemic Toxin Head Swelling), use Gan Jie Tang (Licorice and Platycodon Decoction) plus Shu Niu Zi, Da Huang, Mang Xiao.
[Zhu Zhenheng (Danxi)] Da Tou Tian Xing Bing (Big Head Epidemic Disease).
Qiang Huo (Notopterygium Rhizome), Jiu Qin (Wine-processed Scutellaria Root), Jiu Zheng Da Huang (Wine-steamed Rhubarb Root).
[*Su Wen*] Jue of Ju Yang (Taiyang) meridian leads to head swelling and heaviness. (Full text see "Jue".)
[*Shan*] For Da Tou Feng (Big Head Wind), apply mixture of well-bottom mud, Da Huang, and Mang Xiao externally. (Contraindicated for exterior syndromes, indicated for interior syndromes.)
Yun Qi (Five Movements and Six Qi) Theory: Da Tou Bing all belong to Fire. As the classic states, "swelling above" refers to this category. The classic says: When Shaoyang governs the Heaven, Wind and Heat distribute together, Taiyin dampness flows horizontally, Cold arrives out of season. People suffer from upper body disorders, oppression, swelling, and color changes. It also says: When Shaoyin governs the Heaven, Heat diseases arise above, Cold diseases arise below. People suffer from dry throat and upper swelling. In the final Qi, Dryness command prevails, residual fire is blocked internally, causing upper swelling, cough, and asthma. The treatment formula, Dongyuan's Pu Ji Xiao Du Yin Zi, fits this perfectly.