头痛短涩脉病乖。浮滑风痰必易解。寸口紧急或短或浮或弦。皆主头痛。
夫头者。诸阳所聚之处也。诸阴至颈而还。惟足厥阴有络。上头至颠顶。其脉浮紧弦长
洪大
者。属风热痰火而致也。其脉微弱虚濡者。属气血两虚。必丹田竭而髓海空虚。为难治也。
其有真头痛者。脉无神而脑中劈痛。其心神烦乱。为真头痛也。旦发夕死。夕发旦死。盖头
痛暴起者。如鼻塞发热恶寒。乃感冒所致也。其曰头痛者。有虚有火。有痰厥。有偏有正
其偏
于左边头痛者。宜小柴胡汤加川芎、当归、防风、羌活。其偏于右边头痛者。补中益气汤加
白芷、独活、蔓荆子、酒芩。其眉棱处痛者。二陈汤加酒炒片芩、羌活、薄荷。其脑顶痛者
宜人参败毒散加川芎、 本、酒炒黄柏、木瓜、红花、酒炒大黄。
一论一切头痛主方。不问左右偏正新久。皆效。
清上蠲痛汤
当归（酒洗一钱） 小川芎（一钱） 白芷（一钱） 细辛（三分） 羌活（一钱） 防
风（一钱） 菊花（五分） 蔓荆子（五分） 苍术（米泔浸一钱） 麦冬（一钱） 独活（一钱） 生
甘草（三分） 片芩（酒炒一钱五分）
上锉一剂。生姜煎服。
一左边痛者。加红花七分。柴胡一钱。龙胆草酒洗七分。生地黄一钱。
一右边痛者。加黄 一钱。干葛八分。
一正额上眉棱骨痛者。食积痰壅。用天麻五分。半夏一钱。山楂一钱。枳实一钱。
一当头顶痛者。加 本一钱。大黄酒洗一钱。
一风入脑髓而痛者。加麦门冬一钱。苍耳子一钱。木瓜、荆芥各五分。
一气血两虚。常有自汗。加黄 一钱五分。人参、白芍、生地黄各一钱。
一论年深日近偏正头疼。又治肝脏久虚。血气衰弱。风毒之气。上攻头脑而痛。头眩目
晕。怔忡烦热。百节酸疼。脑昏目痛。鼻塞声重。项背拘急。皮肤瘙痒。面上游风。状若
虫行。及一切头风。兼治妇人血风。攻注头目昏痛。并皆治之。
追风散
防风（去芦一两） 荆芥穗（一两） 羌活（五钱） 川芎（一两） 白芷（五钱） 石膏（煨一
两）
全蝎（去头尾五钱） 白僵蚕（炒二两） 白附子（炮五钱） 天南星（炮一两） 天麻（五钱） 地
龙（五钱） 川乌（炮去皮尖一两） 草乌（炮去皮尖一两） 雄黄（二钱五分） 乳香（二钱五分）
没药（二钱五分） 甘草（炙一两）
上为细末。每服五分。茶汤调。食后临卧服。清头目。利咽膈。消风化痰。
一论痰厥头痛。其症眼黑头旋。恶心烦闷。气短促上喘。无力以言。心神颠倒。目不敢
开。
如在风云中。头苦痛如裂。身重如山。四肢厥冷。不得安卧。此乃胃气虚损。停痰而致也。
半夏白术天麻汤
黄柏（酒洗二分半） 干姜（炒二分） 泽泻 白茯苓（去皮） 天麻 黄 （蜜炒） 人参
苍术
（米泔浸炒各五分） 神曲（炒） 白术（去芦炒） 半夏（姜炒） 陈皮（各八分） 麦芽（炒七分）
上锉。生姜三片。水煎。热服。可一剂而愈。
一论头痛偏左者。属血虚火盛也。
加味四物汤
当归 川芎 生地黄 黄柏（酒炒） 知母（酒炒） 蔓荆子 黄芩（酒炒） 黄连
（酒炒） 栀子（炒各等分）
上锉一剂。水煎。温服。风盛。加防风、荆芥。
一论头痛偏右者。属痰与气虚也。
黄 益气汤
黄 （蜜炙） 人参 白术（去芦） 陈皮 半夏（姜汁炒） 当归（酒洗） 川芎 本 甘
草（炙各五分） 升麻 黄柏（酒炒） 细辛（各三分）
上锉一剂、姜、枣煎服。
一论头左右俱痛者。气血两虚也。
调中益气汤
黄 （蜜炒） 人参 甘草（炙） 苍术（米泔浸炒） 川芎（各六分） 升麻 柴胡 陈皮
黄柏（酒炒） 蔓荆子（各三分） 当归（六分） 细辛（二分）
上锉一剂。水煎温服。
一论偏正头风。一切头痛。诸风眩晕。头目昏重。
都梁丸
香白芷切碎。晒干为细末。炼蜜为丸。如弹子大。每服一丸。荆芥穗腊茶细嚼下。
一论眉棱骨痛者。风热并痰也。
选奇汤
羌活 防风（各二钱） 酒片芩（一钱五分冬月不用或甚者炒用） 半夏（姜汁炒二钱） 甘
草（一钱夏月生冬月炙）
上锉一剂。水煎。食后服。
一论雷头风者。头痛而起核块也。头面疙瘩。恶寒发热拘急。状如伤寒。
升麻汤
升麻 苍术（米泔浸） 薄荷叶（各等分）
上锉。水煎服。
一谭侍御但头痛即吐清水。不拘冬夏。吃姜便止。已三年矣。余作中气虚寒。用六君子
加当归、黄 、木香、炮姜而瘥。
一论颈项强急筋痛。不能回顾者。乌药顺气散加羌活、独活、木瓜。
一治偏正头痛头风。
羌活 细辛 白芷 川芎 蔓荆子 薄荷 防风 甘草（各等分）
上为细末。每服二三茶匙。白汤调下。
一人头痛发热。眩晕喘急。痰涎壅盛。小便频数。口干引饮。遍舌生刺。缩敛如荔枝然
下
唇黑裂。面目俱赤。烦躁不寐。或时喉间如烟火上冲。急饮凉茶少解。已至于死。脉洪大无
伦。且有力。扪其身烙手。此肾经虚火。游行于外。投以十全大补加山茱萸、泽泻、牡丹
、山药、麦冬、五味、附子。一剂熟睡良久。脉症略减三四。再以八味丸服之。诸症悉退
后畏冷物而痊。
一治头风肿痛。偏正不拘。用艾捶烂。铺纸上。将筷卷成筒。次将黄蜡熔化。灌入筒内
以满为度。如左边疼。将药烧烟入右耳。右熏左即安。
一论半边头痛。
祛痛膏
防风 羌活 本 细辛 菊花（各五分） 南星 草乌 白芷（各一钱）
上为细末。用连须葱一把洗净。同前药捣成膏。铜锅顿热。量痛大小。以油纸摊药。贴
痛处
周遭以生面糊封之。再用干帕包定。其痛即止。一方。加菊花、独活各一钱五分。草乌一
钱。麝香一分。
Headache with a short and choppy pulse indicates pathogenic deviation. If the pulse is floating and slippery, it is caused by wind-phlegm and will certainly be easy to resolve. A tight, short, floating, or wiry pulse at the Cun Kou position all indicate headache.
The head is the gathering place of all Yang meridians. All Yin meridians return upon reaching the neck; only the Foot-Jueyin (Liver) meridian has collateral branches ascending to the vertex. Pulses that are floating, tight, wiry, long, or surging belong to wind-heat or phlegm-fire. Pulses that are weak, thready, deficient, or soft belong to deficiency of both Qi and Blood, inevitably leading to exhaustion of the Dantian and emptiness of the Sea of Marrow, which are difficult to treat.
Among these, there is "True Headache" (Zhen Tou Tong), characterized by a spiritless pulse and splitting pain in the brain, accompanied by mental restlessness and chaos. This is True Headache. Death occurs if onset is in the morning and evening, or vice versa. Generally, sudden onset of headache accompanied by nasal congestion, fever, and aversion to cold is caused by exogenous contraction (Gan Mao). Headaches can be due to deficiency, fire, phlegm-jue, lateral (one-sided), or central types. For lateral headache on the left side, Xiao Chai Hu Tang (Minor Bupleurum Decoction) should be used with added Chuanxiong Radix (Chuanxiong Rhizome), Danggui Radix (Angelicae Sinensis Radix), Fangfeng Radix (Saposhnikoviae Radix), and Qianghuo Radix (Notopterygii Rhizomatis et Radicis). For lateral headache on the right side, Buyi Zhongyi Tang (Tonify the Middle and Augment the Qi Decoction) should be used with added Baizhi Radix Angelicae Dahuricae (Dahurian Angelica Root), Duhuo Radix (Angelicae Pubescentis Radix), Manjingzi Fructus Viticis (Viticis Fructus), and Jiuhuangqin (Huangqin Radix Scutellariae fried with wine). For pain at the brow ridge, Er Chen Tang (Two-Cured Decoction) should be used with added Jiupianqin (Pianqin Radix Scutellariae fried with wine), Qianghuo, and Bohe Herba Menthae (Mint Herb). For pain at the vertex, Renshen Baidu San (Ginseng Rescue the Ten Thousand Toxin Powder) should be used with added Chuanxiong, Bencao (Ligustici Rhizoma, specifically Gaoben), Jiuhuangbai (Huangbai Cortex Phellodendri fried with wine), Mugua Fructus Chaenomelis (Chaenomeles Fruit), Honghua Flos Carthami (Safflower), and Jiudahuang (Rhubarb Radix fried with wine).
One discussion presents a main formula for all headaches, effective regardless of lateral/central or new/old nature.
Qingshang Juantong Tang (Clear the Upper and Eliminate Pain Decoction)
Danggui Radix (Washed with wine, 1 qian)
Xiao Chuanxiong Rhizome (1 qian)
Baizhi Radix Angelicae Dahuricae (1 qian)
Xixin Herba Asari (3 fen)
Qianghuo Radix (1 qian)
Fangfeng Radix (1 qian)
Juhua Flos Chrysanthemi (5 fen)
Manjingzi Fructus Viticis (5 fen)
Cangzhu Rhizoma Atractylodis Macrocephalae (Soaked in rice wash water, 1 qian)
Maidong Radix Ophiopogonis (1 qian)
Duhuo Radix (1 qian)
Sheng Gancao Radix Glycyrrhizae (3 fen)
Pianqin Radix Scutellariae (Fried with wine, 1.5 qian)
Decoct one dose with Shengjiang (Fresh Ginger).
For left-sided pain, add Honghua (1.7 qian), Chaihu Radix Bupleuri (1 qian), Longdancao Herba Gentianae (Washed with wine, 1.7 qian), and Sheng Dihuang Radix Rehmanniae (1 qian).
For right-sided pain, add Huangqi Radix Astragali (1 qian), Gange Radix Puerariae (0.8 qian).
For pain at the frontal brow ridge due to food stagnation and phlegm turbidity, use Tianma Rhizoma Gastrodiae (0.5 qian), Banxia Rhizoma Pinelliae (1 qian), Shanzha Fructus Crataegi (1 qian), and Zhishi Fructus Aurantii Immaturus (1 qian).
For vertex pain, add Gaoben Ligustici Rhizoma (1 qian), Dahuang Radix (Washed with wine, 1 qian).
For pain due to wind entering the brain marrow, add Maimendong Radix Ophiopogonis (1 qian), Cangerzi Fructus Xanthii (1 qian), Mugua, and Jingjie Herba Schizonepetae (each 0.5 qian).
For deficiency of both Qi and Blood with spontaneous sweating, add Huangqi (1.5 qian), Renshen Radix Ginseng, Baishao Radix Paeoniae Alba, and Sheng Dihuang (each 1 qian).
One discussion addresses chronic lateral or central headaches, as well as liver deficiency with weakened Qi and Blood, where wind-toxic qi attacks the head causing headache, dizziness, palpitations, heat, joint soreness, brain fog, eye pain, nasal congestion, heavy voice, neck/back stiffness, skin itching, wandering wind on the face resembling insects crawling, and all types of head wind. It also treats women's blood wind attacking the head and eyes causing dizziness and pain.
Zhuifeng San (Wind-Chasing Powder)
Fangfeng Radix (De-rhizome, 1 liang)
Jingjiesui Herba Schizonepetae Spike (1 liang)
Qianghuo Radix (5 qian)
Chuanxiong Rhizome (1 liang)
Baizhi Radix Angelicae Dahuricae (5 qian)
Shigypsum Fibrosum (Roasted, 1 liang)
Quanxie Scorpio (De-head and tail, 5 qian)
Baijiangcan Bombyx Batryticatus (Stir-fried, 2 liang)
Baifuzi Radixaconiti Preparata (Processed, 5 qian)
Tiannanxing Rhizoma Arisaematis (Processed, 1 liang)
Tianma Rhizoma Gastrodiae (5 qian)
Dilong Earthworm (5 qian)
Chuanwu Radix Aconiti Lateralis Preparata (Processed, de-skin and tip, 1 liang)
Caowu Radix Aconiti Preparata (Processed, de-skin and tip, 1 liang)
Xiongyellow Realgar (2.5 qian)
Ruxiang Resina Draconis (2.5 qian)
Moyao Resina Boswelliae (2.5 qian)
Gancao Radix Glycyrrhizae (Roasted, 1 liang)
Grind into fine powder. Take 5 qian per dose, mixed with tea water, after meals before bed. Clears head and eyes, benefits throat and diaphragm, dispels wind and resolves phlegm.
One discussion addresses Phlegm-Jue Headache, with symptoms of black vision and spinning head, nausea and oppression, shortness of breath and wheezing, inability to speak, mental confusion, inability to open eyes, feeling as if in wind and clouds, severe splitting headache, heaviness like mountains, cold limbs, and inability to lie down. This is caused by deficiency of Stomach Qi and retained phlegm.
Banxia Baizhu Tianma Tang (Pinellia, Atractylodes Macrocephala, and Gastrodia Decoction)
Huangbai Cortex Phellodendri (Washed with wine, 2.5 fen)
Ganjiang Rhizoma Zingiberis (Stir-fried, 2 fen)
Zexia Rhizoma Alismatis
Baifuling Poria (De-bark)
Tianma Rhizoma Gastrodiae
Huangqi Radix Astragali (Honey-roasted)
Renshen Radix Ginseng
Cangzhu Rhizoma Atractylodis Macrocephalae (Soaked in rice wash water and stir-fried, each 5 fen)
Shenqu Mass Medicamentum Fermentatum (Stir-fried)
Baizhu Rhizoma Atractylodis Macrocephalae (De-rhizome and stir-fried)
Banxia Rhizoma Pinelliae (Stir-fried with ginger juice)
Chenpi Pericarpium Citri Reticulatae (Each 8 fen)
Maiya Fructus Hordei Germinatus (Stir-fried, 7 fen)
Decoct with 3 slices of Shengjiang. Drink hot. One dose may cure.
One discussion states that headache on the left belongs to Blood deficiency with flourishing Fire.
Jiawei Siwu Tang (Modified Four Substances Decoction)
Danggui Radix
Chuanxiong Rhizome
Sheng Dihuang Radix Rehmanniae
Huangbai Cortex Phellodendri (Stir-fried with wine)
Zhimu Cortex Anemarrhenae (Stir-fried with wine)
Manjingzi Fructus Viticis
Huangqin Radix Scutellariae (Stir-fried with wine)
Huanglian Rhizoma Coptidis (Stir-fried with wine)
Zhizi Fructus Gardeniae (Stir-fried, equal parts)
Decoct one dose, drink warm. If Wind is excessive, add Fangfeng and Jingjie.
One discussion states that headache on the right belongs to Phlegm and Qi deficiency.
Huangqi Yiqi Tang (Astragalus Qi-Augmenting Decoction)
Huangqi Radix Astragali (Honey-roasted)
Renshen Radix Ginseng
Baizhu Rhizoma Atractylodis Macrocephalae (De-rhizome)
Chenpi Pericarpium Citri Reticulatae
Banxia Rhizoma Pinelliae (Stir-fried with ginger juice)
Danggui Radix (Washed with wine)
Chuanxiong Rhizome
Gaoben Ligustici Rhizoma
Gancao Radix Glycyrrhizae (Roasted, each 5 fen)
Shengma Rhizoma Cimicifugae
Huangbai Cortex Phellodendri (Stir-fried with wine)
Xixin Herba Asari (Each 3 fen)
Decoct one dose with Jiang (Ginger) and Zao (Jujube).
One discussion states that headache on both sides belongs to deficiency of both Qi and Blood.
Tiaozhong Yiqi Tang (Regulate the Middle and Augment Qi Decoction)
Huangqi Radix Astragali (Honey-roasted)
Renshen Radix Ginseng
Gancao Radix Glycyrrhizae (Roasted)
Cangzhu Rhizoma Atractylodis Macrocephalae (Soaked in rice wash water and stir-fried)
Chuanxiong Rhizome (Each 6 fen)
Shengma Rhizoma Cimicifugae
Chaihu Radix Bupleuri
Chenpi Pericarpium Citri Reticulatae
Huangbai Cortex Phellodendri (Stir-fried with wine)
Manjingzi Fructus Viticis (Each 3 fen)
Danggui Radix (6 fen)
Xixin Herba Asari (2 fen)
Decoct one dose, drink warm.
One discussion addresses lateral/central head wind, all headaches, various wind vertigos, and heavy/dizzy head and eyes.
Duliang Wan (Duliang Pill)
Xiang Baizhi Radix Angelicae Dahuricae is chopped, dried, and ground into fine powder. Form pills with refined honey, size of a bullet. Take one pill per dose, chewed finely with Jingjiesui and dark tea.
One discussion states that brow ridge pain is due to wind-heat combined with phlegm.
Xuanqi Tang (Select Wonder Decoction)
Qianghuo Radix
Fangfeng Radix (Each 2 qian)
Jiu Pianqin Radix Scutellariae (1.5 qian, not used in winter, or stir-fried if severe)
Banxia Rhizoma Pinelliae (Stir-fried with ginger juice, 2 qian)
Gancao Radix Glycyrrhizae (1 qian, raw in summer, roasted in winter)
Decoct one dose, take after meals.
One discussion addresses Thunder Head Wind, characterized by headache with nodules, facial lumps, aversion to cold, fever, stiffness, resembling Taiyang disease.
Shengma Tang (Cimicifuga Decoction)
Shengma Rhizoma Cimicifugae
Cangzhu Rhizoma Atractylodis Macrocephalae (Soaked in rice wash water)
Boheye Herba Menthae (Equal parts)
Decoct and take.
Attendant Tan suffered from vomiting clear fluid whenever he had a headache, regardless of season, relieved by eating ginger, for three years. I diagnosed it as Middle Qi deficiency and Cold, treated with Liujunzi Tang (Six-Gentlemen Decoction) plus Danggui, Huangqi, Muxiang Radix Aucklandiae, and Paojiang (Roasted Ginger), resulting in recovery.
One discussion addresses stiff neck and back pain preventing turning the head: Wuyao Shunqi San (Aucklandia Regulating Qi Powder) plus Qianghuo, Duhuo, and Mugua.
One treatment for lateral/central headache and head wind:
Qianghuo Radix
Xixin Herba Asari
Baizhi Radix Angelicae Dahuricae
Chuanxiong Rhizome
Manjingzi Fructus Viticis
Bohe Herba Menthae
Fangfeng Radix
Gancao Radix Glycyrrhizae (Equal parts)
Grind into powder. Take 2-3 tea spoons per dose, mixed with plain water.
A patient suffered from headache, fever, dizziness, wheezing, profuse phlegm, frequent urination, dry mouth with desire to drink, prickles all over the tongue shrinking like a lychee, cracked black lower lip, red face and eyes, irritability and insomnia, occasional sensation of smoke/fire rising in the throat, temporarily relieved by drinking cold tea, nearing death. The pulse was surging, large, boundless, and forceful; body felt burning hot to touch. This is Deficient Fire of the Kidney Meridian roaming externally. Administer Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction) plus Shanzhuyu Fructus Corni, Zexia Rhizoma Alismatis, Mudanpi Cortex Moutan, Shanyao Rhizoma Dioscoreae, Maidong Radix Ophiopogonis, Wuweizi Fructus Schisandrae, and Fuzi Radix Aconiti Preparata. After one dose, slept soundly for a long time, pulse and symptoms reduced by 30-40%. Then administered Bawei Wan (Eight-Ingredient Pill), all symptoms receded, recovered while avoiding cold objects.
One treatment for head wind swelling and pain, lateral or central: Crush Ai Ye (Mugwort Leaf), spread on paper, roll yellow wax into a tube using chopsticks, melt Huangla (Yellow Beeswax) and fill the tube. If left side hurts, burn the medicine and smoke into the right ear; smoking the right cures the left.
One discussion addresses half-head headache.
Qtong Gao (Pain-Relieving Plaster)
Fangfeng Radix
Qianghuo Radix
Gaoben Ligustici Rhizoma
Xixin Herba Asari
Juhua Flos Chrysanthemi (Each 5 fen)
Nanxing Rhizoma Arisaematis
Caowu Radix Aconiti Preparata
Baizhi Radix Angelicae Dahuricae (Each 1 qian)
Grind into powder. Wash a bunch of Congbai (Scallion White with roots), mash together with the herbs into a paste. Heat a copper pot, spread the medicine on oil paper according to pain size, apply to the painful area, seal around with raw flour paste, wrap with dry cloth. Pain stops immediately. Another formula adds Juhua and Duhoge (each 1.5 qian), Caowu (1 qian), and Shexiang Moschus (1 fen).