头痛痰热风湿气，或兼气血虚而疼，在右属气多痰热，左属血少更属风，因风眩晕
头风痛，热晕烦渴火上攻，气郁不伸痰呕吐，湿则重痛虚动增。
【注】头痛，属痰、属热、属风、属湿、属气，或兼气虚、血虚。因风而痛，谓之头
风，必眩晕。因热而痛晕者，则烦渴。因气郁而痛晕者，则志意不伸。因痰而痛晕者，则
呕吐痰涎。因湿而痛晕者，则头重不起。因虚而痛晕者，动则更痛更晕也。
真头脑痛朝夕死，手足厥逆至节青，泻多眩晕时时冒，头卒大痛目瞀凶。
【注】真头痛，痛连脑内，手足青冷至肘膝之节，朝发夕死。凡头痛眩晕，时时迷冒，
及头目卒然大痛，目视不见，或泻多之后，皆凶证也。
荜茇散 芎芷石膏汤
头风 鼻热荜茇，湿盛瓜蒂入茶茗，风盛日久三圣散，内服芎芷石膏灵。芎芷石膏
菊羌 ，苦加细辛风防荆，热加栀翘芩薄草，便秘尿红硝黄攻。
【注】一切头风兼热者，以荜茇散 鼻。即荜茇一味为末，用猪胆汁拌过 之，作嚏
立愈。一切头风兼湿者，以瓜蒂、松萝茶，二味为末， 之出黄水立愈，头风风盛时发，日
久不愈，则多令人目昏，以三圣散 之，方在中风门内。用芎芷石膏汤，即芎、芷、石
膏、菊花、羌活、 本也。苦痛者加细辛，风
盛目昏加防风、荆芥穗，热盛加栀子、连翘、黄芩、薄荷、甘草，大便秘小便赤加硝、黄，
攻之自愈也。
茶调散 清震汤 滚痰丸 人参芎附汤
风热便利茶调散，雷头荷叶苍与升，痰热滚痰芎作引，虚寒真痛附参芎。
【注】雷头风痛，头面疙瘩，耳闻雷声，宜清震汤，即荷叶、苍术、升麻也。人参芎
附汤，即人参、川芎、川附也。
芎犀丸
偏正头风芎犀丸，血虚四物薄羌天，气虚补中加芎细，气逆降气黑锡丹。
【注】血虚，面少血色，或久脱血也。天，天麻也。降气，苏子降气汤也。
芎麻汤 半夏白术天麻汤
欲吐晕重风痰痛，芎麻汤下白丸宁，虚者六君 干柏，天麻曲 泽苍同。
【注】麻，天麻也。白丸，青州白丸子也。虚者，谓风痰兼气虚者，宜半夏白术天麻汤，
即六君子加黄 、干姜、黄柏、天麻、神曲、麦 、泽泻、苍术也。
荆穗四物汤
头晕头痛同一治，血虚物穗气补中，气血两虚十全补，上盛下虚黑锡灵。
【注】头晕之虚实寒热诸证，同乎头痛一治法也。其有因血虚，宜用荆穗四物汤，即
当归、川芎、白芍、熟地黄、荆芥穗也。气虚，宜用补中益气汤。气血两虚，宜用十全
大补汤。上盛下虚，宜用黑锡丹。
Headache can be caused by phlegm, heat, wind, dampness, or qi pathogenic factors, or accompanied by deficiency of qi and blood. When located on the right side, it mostly belongs to qi stagnation and phlegm-heat; when located on the left side, it mostly belongs to blood deficiency and is more related to wind. Dizziness caused by wind is called "head wind" (Toufeng); dizziness caused by heat is accompanied by irritability and thirst, due to fire attacking upwards; dizziness caused by qi depression is accompanied by vomiting of phlegm-saliva, due to turbid phlegm rising; dizziness caused by dampness is accompanied by heavy pain in the head, due to dampness obstructing; dizziness caused by deficiency worsens with movement.
[Note] Headache is attributed to phlegm, heat, wind, dampness, and qi, or accompanied by qi deficiency and blood deficiency. Pain caused by wind is called "head wind," inevitably accompanied by vertigo. Pain and vertigo caused by heat are accompanied by irritability and thirst. Pain and vertigo caused by qi depression are accompanied by a sense of oppression in the mind. Pain and vertigo caused by phlegm are accompanied by vomiting of phlegm-saliva. Pain and vertigo caused by dampness are accompanied by heaviness in the head that is difficult to lift. Pain and vertigo caused by deficiency intensify upon movement.
True headache (Zhen Toutong), where pain reaches the brain, results in death from morning to evening if accompanied by cold limbs turning blue up to the elbows and knees; excessive diarrhea leading to vertigo and frequent fainting, or sudden severe headache with blurred vision, indicates a critical prognosis.
[Note] True headache involves pain extending into the brain, with cold and blue limbs reaching the elbow and knee joints; onset in the morning leads to death by evening. Any case of headache and vertigo with frequent confusion and fainting, or sudden severe pain in the head and eyes causing blindness, or occurring after excessive diarrhea, represents a critical condition.
Bibo San (Periplanetae Powder) and Xiong Zhi Shi Gao Tang (Ligusticum, Angelica Dahurica, and Gypsum Decoction).
For head wind with nasal heat, use Bibo San; for excess dampness, use Citrulli Fructus Seed (Gua Di) with tea; for prolonged excess wind, use San Sheng San (Three Holy Powders); internally take Xiong Zhi Shi Gao Tang. Xiong Zhi Shi Gao Tang contains Chuanxiong Rhizome (Chuanxiong), Angelicae Dahuricae Radix (Baizhi), Gypsum Fibrosum (Shigao), Chrysanthemi Flos (Juhua), Notopterygii Rhizoma et Radix (Qianghuo), and Ligustici Rhizoma et Radix (Gaoben). For severe pain, add Asari Radix et Rhizoma (Xixin); for excess wind and blurred vision, add Saposhnikoviae Radix (Fangfeng) and Schizonepetae Spica (Jingjie Sui); for excess heat, add Gardeniae Fructus (Zhizi), Forsythiae Fructum (Lianqiao), Scutellariae Radix (Huangqin), Menthae Haplocalycis Herba (Bohe), and Glycyrrhizae Radix et Rhizoma (Gancao); for constipation and red urine, use Mirabilite (Xiaofen) and Rhei Radix et Rhizoma (Dahuang) to purge.
[Note] For all head winds accompanied by heat, use Bibo San insufflated into the nose. This consists of single herb Periplocae Semen (Bibo) ground into powder, mixed with porcine bile, insufflated to induce sneezing for immediate relief. For all head winds accompanied by dampness, use Citrulli Fructus Seed (Gua Di) and Poria Cocos with Tea (Songluo Cha) ground into powder, insufflated to induce discharge of yellow fluid for immediate relief. When head wind flares due to excess wind and persists for a long time, it often causes blurred vision; use San Sheng San to induce vomiting, found in the Wind Stroke section. Use Xiong Zhi Shi Gao Tang, which consists of Chuanxiong Rhizome (Chuanxiong), Angelicae Dahuricae Radix (Baizhi), Gypsum Fibrosum (Shigao), Chrysanthemi Flos (Juhua), Notopterygii Rhizoma et Radix (Qianghuo), and Ligustici Rhizoma et Radix (Gaoben). For bitter pain, add Asari Radix et Rhizoma (Xixin); for excess wind and blurred vision, add Saposhnikoviae Radix (Fangfeng) and Schizonepetae Spica (Jingjie Sui); for excess heat, add Gardeniae Fructus (Zhizi), Forsythiae Fructum (Lianqiao), Scutellariae Radix (Huangqin), Menthae Haplocalycis Herba (Bohe), and Glycyrrhizae Radix et Rhizoma (Gancao); for constipation and red urine, use Mirabilite (Xiaofen) and Rhei Radix et Rhizoma (Dahuang) to purge, leading to self-healing.
Chatiao San (Tea-Powdered Dispersion), Qingzhen Tang (Clear Trembling Decoction), Untan Wan (Rolling Phlegm Pill), and Renshen Xiongfu Tang (Ginseng, Ligusticum, and Aconite Decoction).
For wind-heat with normal bowel movements, use Chatiao San; for Thunderhead Wind, use Qingzhen Tang composed of Nelumbinis Folium (Heye), Atractylodis Rhizoma (Cangzhu), and Cimicifugae Rhizoma (Shengma); for phlegm-heat, use Untan Wan with Chuanxiong Rhizome (Chuanxiong) as a guide; for deficiency-cold true headache, use Renshen Xiongfu Tang composed of Ginseng Radix et Rhizoma (Renshen), Chuanxiong Rhizome (Chuanxiong), and Aconiti Lateralis Radix Praeparata (Chuanfu).
[Note] Thunderhead Wind involves pain with nodules on the head and face, and hearing thunderous sounds; Qingzhen Tang is indicated, consisting of Nelumbinis Folium (Heye), Atractylodis Rhizoma (Cangzhu), and Cimicifugae Rhizoma (Shengma). Renshen Xiongfu Tang consists of Ginseng Radix et Rhizoma (Renshen), Chuanxiong Rhizome (Chuanxiong), and Aconiti Lateralis Radix Praeparata (Chuanfu).
Xiongxī Wan (Ligusticum and Rhinoceros Horn Pill).
For lateral and frontal head wind, use Xiongxī Wan; for blood deficiency, use Siwu Tang (Four Substances Decoction) plus Menthae Haplocalycis Herba (Bohe), Notopterygii Rhizoma et Radix (Qianghuo), and Gastrodiae Rhizoma (Tianma); for qi deficiency, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Chuanxiong Rhizome (Chuanxiong) and Asari Radix et Rhizoma (Xixin); for rebellious qi, use Heixi Dan (Black Tin Pill) for descending qi.
[Note] Blood deficiency presents with pale complexion or follows chronic blood loss. Tian refers to Gastrodiae Rhizoma (Tianma). Jiangqi refers to Suzi Jiangqi Tang (Perilla Fruit Descending Qi Decoction).
Xiongmā Tang (Ligusticum and Gastrodia Decoction) and Banxia Baizhu Tianma Tang (Pinellia, Atractylodes Macrocephala, and Gastrodia Decoction).
For nausea, heavy vertigo, and wind-phlegm headache, use Xiongmā Tang combined with Qingzhou Baiwan (Qingzhou White Pill) to calm symptoms; for deficiency patterns, use Liujunzi Tang (Six Gentlemen Decoction) plus Zingiberis Rhizoma Recens (Ganjiang) and Phellodendri Cortex (Huangbai), along with Gastrodiae Rhizoma (Tianma), Maltum (Shenqu), and Alismatis Rhizoma (Zexie), Atractylodis Rhizoma (Cangzhu).
[Note] Ma refers to Gastrodiae Rhizoma (Tianma). Baiwan refers to Qingzhou Baiwan (Qingzhou White Pill). Deficiency pattern refers to wind-phlegm accompanied by qi deficiency; Banxia Baizhu Tianma Tang is indicated, which is Liujunzi Tang plus Astragali Membranacei Radix (Huangqi), Zingiberis Rhizoma Recens (Ganjiang), Phellodendri Cortex (Huangbai), Gastrodiae Rhizoma (Tianma), Maltum (Shenqu), Hordei Fructus Germinatus (Maiya), Alismatis Rhizoma (Zexie), and Atractylodis Rhizoma (Cangzhu).
Jingsui Siwu Tang (Schizonepeta and Four Substances Decoction).
Vertigo and headache share the same treatment principle: for blood deficiency, use Jingsui Siwu Tang; for qi deficiency, use Buzhong Yiqi Tang; for dual qi and blood deficiency, use Shiquan Dabu Tang (Ten Complete Tonification Decoction); for upper excess and lower deficiency, use Heixi Dan (Black Tin Pill).
[Note] Various patterns of vertigo involving deficiency, excess, cold, and heat are treated similarly to headache. For cases due to blood deficiency, Jingsui Siwu Tang is indicated, consisting of Angelicae Sinensis Radix (Danggui), Chuanxiong Rhizome (Chuanxiong), Paeoniae Radix Alba (Baishao), Rehmanniae Radix Praeparata (Shudihuang), and Schizonepetae Spica (Jingjie Sui). For qi deficiency, Buzhong Yiqi Tang is indicated. For dual qi and blood deficiency, Shiquan Dabu Tang is indicated. For upper excess and lower deficiency, Heixi Dan is indicated.