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Da Tou Wen (Big Head Plague) is caused by epidemic pathogenic toxins invading the channels of the Three Yang meridians, resulting in aversion to cold and fever, swelling of the head, eyes, neck, and even the throat, with redness of the cheek and face, and macular swelling on the shoulders and back, resembling a toad; hence it is also called Xia Ma Wen (Toad Plague). Generally, this condition belongs to Wind-Heat, yet there are distinctions between exterior/interior and deficiency/excess. Additionally, in surgery, there is a condition called Shi Du (Seasonal Toxicity), which is essentially the same disease. The prescriptions and treatments are detailed in the relevant section and should be consulted for use.

1. Treatment Method for Da Tou Xia Ma Wen: For cases where the pathology is located in the head and eyes, and internal fire has not yet become excessive, dispersing treatment should be applied first. Zheng Chai Hu Yin (Correct Bupleurum Decoction) or Bai Du San (Detoxicate Powder) are suitable. If seasonal toxicity causes sore throat and swelling, with mild internal fire and harmonized bowel movements, Ge Gen Niu Bang Tang (Kudzu and Burdock Decoction) is indicated. If seasonal toxicity presents with heat in both the interior and exterior, and swelling of the head and eyes, requiring clearing and dispersing, Chai Ge Jian (Bupleurum and Kudzu Decoction) is used. If the toxin is in the Yangming channel, with heat in both interior and exterior, often accompanied by headache and dry nose, requiring dispersing, Chai Ge Jie Ji Tang (Bupleurum and Kudzu Decoction to Resolve the Muscle Layer) is appropriate. If seasonal toxicity involves the Three Yang channels, with extreme heat causing mania and restlessness, and sore throat and swelling, requiring clearing combined with dispersing, Zhi Zi Ren Tang (Gardenia Seed Decoction) is used. If seasonal toxicity spreads throughout, with pathogenic heat floating upward, causing swelling of the head and face and difficulty in the throat, Pu Ji Xiao Du Yin (Universal Benefit Decoction to Eliminate Toxins) is indicated. If wind-heat from seasonal toxicity gathers upward in the head and face, requiring ascending and dispersing, Xi Jiao Sheng Ma Tang (Rhinoceros Horn and Cimicifuga Decoction) is used. If epidemic qi prevails, requiring clearing fire and detoxifying, Qiang Huo Sheng Ma Tang (Notopterygium and Cimicifuga Decoction) is used. If seasonal toxicity involves blood heat with irritability and accompanying red macules, Xi Jiao San (Rhinoceros Horn Powder) or Ren Shen Bai Hu Tang (Ginseng White Tiger Decoction) are used. If seasonal toxicity presents with excess in both interior and exterior, requiring simultaneous resolution of both, Fang Feng Tong Sheng San (Saposhnikovia Powder to Unblock the Hui) is used. If seasonal toxicity causes painful swelling, with a surging pulse and constipation, requiring purgation, Wu Li Da Huang Tang (Five Benefits Rhubarb Decoction), or Lou Lu Sheng Ma Tang (Leuzea and Cimicifuga Decoction), or Lian Qiao Xiao Du San (Forsythia Powder to Eliminate Toxins) are used. If seasonal toxicity is severe but the exterior is excess while the interior is deficient, with a weak pulse and mental fatigue, and evidence of various deficiency syndromes, rescue of the interior and internal support are mandatory. Can Qi Tuo Li San (Ginseng and Internal Support Powder) or Tuo Li Xiao Du San (Internal Support and Toxin-Eliminating Powder) are suitable. In cases of false heat due to Yang deficiency, accompanied by vomiting, nausea, and diarrhea, Liu Wei Hui Yang Yin (Six-Ingredient Decoction to Restore Yang) and similar formulas must be used without hesitation. If swelling of the head and neck is severe and pain is unbearable, Qing Liang Jiu Ku San (Cooling and Suffering-Saving Powder) should be applied externally. Alternatively, natural juice of Ce Bai Ye (Biota Tops) can be mixed with earthworm mud for external application.

Xu Donggao stated: The manifestation of Da Tou Xia Ma is due to wind-heat-damp pathogens residing at the highest point of the body (the vertex). One should initially use Bai Du San (Detoxicate Powder) added with Qiang Huo (Notopterygium Root), Huang Qin (Scutellaria Root), and wine-processed Da Huang (Rhubarb Root and Rhizome), adjusting according to the disease. Harsh descending medicines should not be used vigorously. Even if formulas containing Xiao Shi (Mirabilite) and Da Huang (Rhubarb Root and Rhizome) are employed, they must be sipped slowly. Generally, treating Da Tou Wen does not advocate rapid purgation. If purgation is too harsh, although the pathogenic factors above may be expelled freely, the Middle Qi will suffer damage and harm the person. Moreover, the head is a hollow area; since pathogens reside in this hollowness, they can reach anywhere. Therefore, the treatment method should be slow first and urgent later, allowing the latent pathogens to be addressed. Slow treatment involves clearing heat and eliminating toxins; for deficiency, supplementing Yuan Qi (Primal Qi) is added; for stomach deficiency with poor appetite, assisting Stomach Qi is added; for interior excess with severe heat and constipation, wine-processed Da Huang (Rhubarb Root and Rhizome) is used for purgation to vent heat and drain toxins. This is the method of "slow first, urgent later." If swelling starts from the nose, then spreads to the eyes, then to the ears, gradually reaching the head, and forms lumps behind the brain before stopping, if it does not disperse, pus must emerge before recovery. He also said: Da Tou Wen Taiyang Disease (Taiyang Disorder) manifests on the head, including the back of the head, lower neck, and redness/swelling behind the eyes; treatment should use Jing Fang Bai Du San (Schizonepeta and Saposhnikovia Detoxicate Powder), with Qiang Huo (Notopterygium Root) and Ben Cao (Ligusticum Rhizome) guiding the meridian. Yangming Disease (Yangming Disorder) manifests in the nose, inability to open the eyes, and the face; if accompanied by internal heat, panting, dry mouth and tongue, sore throat and swelling with difficulty, and a rapid and large pulse, Pu Ji Xiao Du Yin (Universal Benefit Decoction to Eliminate Toxins) is used. If there is interior excess and heat, Fang Feng Tong Sheng San (Saposhnikovia Powder to Unblock the Hui) can be taken intermittently. Shaoyang Disease (Shaoyang Disorder) manifests around the ears (upper, lower, front, back) and redness/swelling of the temporal region; if accompanied by fever, afternoon tidal fever, alternating chills and fever, bitter taste in the mouth, dry throat, eye pain, and fullness/stuffiness in the chest and hypochondrium, Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with detoxifying herbs is used.