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Chronic headache that is triggered by slight exposure to wind-cold, requiring heavy cotton and thick scarves for head wrapping in cold months, belongs to the category of constrained heat (Yu Re), where the root is internal heat but the branch manifests as cold. People in the world do not understand this, and usually use acrid-warm exterior-releasing medicines. Although temporary relief is obtained, it is mistakenly considered a cold syndrome. Little do they know that because the patient originally has constrained heat, the pores are often loose, making it easy for wind-cold to enter. The external cold binds the internal heat, causing obstruction and rebellion, leading to pain. Acrid-hot medicines, although capable of opening obstructions and dissipating the branch cold pathogen, add heat to heat, deepening the root of the disease and worsening aversion to cold. Only by focusing on purging fire and cooling blood, while assisting with acrid-warm exterior-dispersing agents to treat according to the method of compliance (Cong Zhi), can the disease be cured and the root eradicated.

In my opinion, the aforementioned symptoms are mostly due to phlegm; severe pain is caused by wind-toxin attacking upwards. Some cases are due to blood deficiency, some to qi stagnation in various meridians, some to qi deficiency, some to external injury from the four climatic factors, and some to injury from overexertion. Some are suitable for emesis, some for purgation; treatment should be differentiated based on excess/deficiency, cold/heat, and complicated variations. As for lateral or frontal headaches (Tou Feng) that persist for a long time, it is often due to internal retention of phlegm-fluids, with wind-fire constrained and blocking the meridians, causing qi and blood stasis. In severe cases, vision becomes blurred, eyes feel tight and small, and urination and defecation become difficult. It is appropriate to use bian stone (stone lancet) to bleed, thereby opening constraints and releasing the exterior. I once treated Liu Yizhai, a Supervisor of the Directorate of Palace Attendants, who experienced pain in both temples whenever he was angry. I first used Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with Fu Ling (Poria) and Shan Zhi (Gardeniae Fructus), followed by Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) to nourish kidney water, after which the condition did not recur.

Tan Shiyu, an Imperial Censor, always vomited clear fluid when suffering from headaches, regardless of winter or summer; eating ginger would stop it. I diagnosed this as middle-jiao qi deficiency and cold, using Liu Jun Zi Tang (Six-Gentlemen Decoction) added with Dang Gui (Angelicae Sinensis Radix), Huang Qi (Astragali Radix), Mu Xiang (Aucklandiae Radix), and Pao Jiang (Prepared Ginger), resulting in recovery.

Shang Yibu, a Department Director of Commerce, suffered from headaches upon exertion. I diagnosed this as yang deficiency failing to ascend, treating him with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) added with Man Jing Zi (Viticis Fructus), resulting in recovery.

For red, swollen, and painful eyes, ancient formulas differed between internal and external treatments. Internally, decoctions and powders used bitter-cold and acrid-cool medicines to purge fire; externally, drops and washes used acrid-hot or acrid-cool medicines to disperse pathogens. Therefore, among eye drops, nothing is more important than Bing Pian (Borneolum Syntheticum). Bing Pian is greatly acrid and hot; due to its extreme acridity, it helps extract fire pathogens and disperse heat. Ancient formulas used rice wine to wash eyes, or applied Gan Jiang (Zingiberis Rhizoma) powder or Sheng Jiang (Zingiberis Rhizoma Recens) juice to the eyes, all following this principle. Generally, red eyes result from fire pathogens flaring internally and attacking upwards to the eyes. Thus, internal treatment uses bitter-cold medicines to address the root, akin to removing firewood from under a pot. However, since the fire pathogen resides in the eye and moves from inside out, if cold-cool medicines are used externally to obstruct it, the constrained fire will attack internally without dispersing. Therefore, eye drops use acrid-hot substances, and eye washes use hot water; this follows the principle "when fire is constrained, release it," dispersing it through compliance, which is the method of Cong Zhi. People in the world do not know that Bing Pian is a drug that劫夺 (seizes/depletes) healthy qi, mistakenly believing it to be cold. Frequent use leads to accumulated heat entering the eyes, causing dimness and nebulae (cataracts/opacities). Hence the saying "eyes do not go blind unless medicated" refers to this. Others do not know that external treatment contraindicates cold-cool substances; recklessly washing with cold water, cold objects, or cold medicines has led to blindness.

In my opinion, if the aforementioned symptoms involve fatigue, poor appetite, blurred vision, or worsening with diet and overexertion, it indicates spleen-stomach deficiency, treated with Bu Zhong Yi Qi Tang. If there is excessive ocular discharge, tightness and astringency, red vessels crossing the eyeball, or organ constipation, use Shao Yao Qing Gan Wan (Peony Liver-Clearing Pill). If white sclera is covered with red nebulae, photophobia, or stabbing pain, it indicates upper-jiao wind-heat, treated with Huang Lian Yin Zi (Coptis Infusion). If prolonged viewing causes visual hallucinations, photophobia, and blurry distance vision, it indicates damage to spirit and qi, treated with Shen Xiao Huang Qi Tang (Miraculous Efficacy Astragalus Decoction). Generally, pain worsening in the morning is treated with Dong Yuan's Zhu Yang Huo Xue Tang (Assist Yang and Invigorate Blood Decoction); pain worsening in the afternoon is treated with Huang Lian Tian Hua Fen Wan (Coptis and Trichosanthes Root Pill); afternoon worsening without pain is treated with Dong Yuan's Yi Yin Shen Qi Wan (Nourish Yin and Kidney Qi Pill). Ability to see near but not far is treated with Di Zhi Wan (Cornus and Dogwood Pill); ability to see far but not near is treated with Ding Zhi Wan (Stabilize Spirit Pill). Thus, Mr. Dong Yuan stated: The essence of the five zang and six fu organs is received from the spleen and ascends to the eyes. The spleen is the head of all yin; the eyes are the congregation of blood vessels. Therefore, spleen deficiency causes the essence of the five zang organs to lose their governance, failing to clarify vision. The heart is the ministerial fire, governing human spirit,宜静而安 (should be quiet and peaceful), while ministerial fire acts on its behalf. Ministerial fire refers to the pericardium, which governs all vessels and nourishes the eyes. Due to physical exertion, the momentum of ministerial fire runs wild; combined with pathogenic invasion damaging the vessels, various diseases arise. Physicians who neglect regulating the spleen and stomach and nourishing blood/calming spirit, treating only the branch and not the root, fail to understand the correct principle. If one indiscriminately uses acrid-cool and bitter-cold agents, healthy qi is damaged, promoting the onset of internal cataracts.

Zhang Yugong, a Remonstrator, had red and unclear eyes. After taking wind-dispersing and heat-clearing medicines, he became more photophobic and experienced heavy hearing, with a large and empty pulse. This was due to excessive mental labor and irregular diet. I used Bu Zhong Yi Qi Tang added with Fu Shen (Poria with Hostwood), Suan Zao Ren (Ziziphus Seed), Shan Yao (Dioscorea Rhizome), Shan Zhu Yu (Cornus Fruit), and Wu Wei Zi (Schisandra Fruit), resulting in immediate recovery. Upon recurrence due to severe exertion, I used Shi Quan Da Bu Tang (Complete Great Tonifying Decoction) combined with the previous herbs, leading to gradual recovery, and finally cured by using Bu Zhong Yi Qi Tang with the aforementioned additions.