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Qin Zi said: Headache and Toufeng (chronic headache/head wind) are the same syndrome. Toufeng is a specific type within headache syndromes; medical texts define chronic, long-lasting pain as Toufeng, while sudden onset pain is defined as headache. This terminology seems to attribute headache to external contraction and Toufeng to internal injury. I believe that although there is a distinction between new and old onset, the differentiation between external contraction and internal injury does not lie here. Both headache and Toufeng ultimately result in pain; if caused by Wind pathogen, it may be named Toufeng. The headaches described in the *Shanghan* (Cold Damage) section are all exterior syndromes of the Three Yang meridians (Taiyang, Yangming, Shaoyang). Now, in the miscellaneous diseases section, although external contraction and internal injury are distinguished, headaches can occur in both the Three Yang and Three Yin meridians (Taiyin, Shaoyin, Jueyin).

[Symptoms of Headache] Initially, without prior internal injury, sudden pain occurs in the forehead and head. Many people in the vicinity fall ill, spreading among adults and children alike. This is due to contracting the climate qi of the annual cycle, known as "Tianxing" syndrome (epidemic disease). If one is careless in daily life, sleeps facing drafts, or suffers from cold and snow exposure, contracting illness without contagion, this is due to the Six Excesses (Wind, Cold, Summerheat, Dampness, Dryness, Fire) pathogenic factors, known as "self-contracted cold" syndrome. If accompanied by aversion to cold and fever, with pain in the nape, vertex, and hairline, it is a Taiyang syndrome. If accompanied by coughing, hiccups, vexation, chest fullness, and frontal headache, it is a Yangming syndrome. If accompanied by alternating chills and fever, with pain at the temples, it is a Shaoyang syndrome. If accompanied by heart pain, vexation, headache radiating to the bones, it is a Shaoyin syndrome. If accompanied by dry retching, vomiting of clear saliva, and vertex headache, it is a Jueyin syndrome. If accompanied by dizziness, fever, and sweating, it is Wind-pain. If accompanied by aversion to cold, fever, and absence of sweat, it is Cold-pain. Headaches occurring in summer with fever, profuse sweating, and thirst are Summerheat-pain. Heavy and painful head, worsening on cloudy days, is Damp-pain. Dry mouth, cracked lips, vexation, and constipation indicate Dryness-pain. Sudden syncope, restlessness, inability to lie down, and heat sensation indicate Fire-pathogen pain.

[Etiology of Headache] When Shaoyang governs, excessive Wind causes tremors, and the climate becomes excessively warm, leading to headache. It is also stated that when Yangming Qi rebounds, coughing, hiccups, and vexation occur, with pathology in the diaphragm, causing headache. When Taiyang Qi prevails, heat rises upward, causing pain in the head, nape, and occiput. When Taiyang Qi rebounds, heart pain, fullness, and headache occur. When Taiyin governs, pain occurs in the lower back, spine, and vertex. It is also stated that when Taiyin is in the Earthly Branch position, excessive Dampness causes rushing headache, eyes feeling as if they will protrude, and neck feeling as if being pulled. These are all effects of the annual cycle superimposed upon the environment. Humans, existing within the intersection of Heaven and Earth Qi, secretly absorb these climatic influences, which stagnate in the meridians, forming Tianxing headache. If not caused by the governing Qi of the annual cycle, but rather due to careless living, sitting or lying in drafts, where Wind, Cold, Summerheat, and Dampness invade the meridians, self-contracted Six Excesses headache results.

[Pulse Diagnosis of Headache] The pulse must be Floating and Large. Floating and Wiry indicates Wind-injury; Floating and Tight indicates Cold-injury. Deficient and Rapid indicates Summerheat; Full and Rapid indicates Heat. A Large Cun (inch) position suggests easier recovery; the Chi (cubit) position... [text cuts off].

[Treatment of Headache] One must carefully distinguish whether it is epidemic or self-contracted, and which meridian is primarily affected. If in the Taiyang meridian, select Xuanqi Decoction. If in the Yangming meridian, select Qingzhen Decoction. For those vomiting saliva, Wuzhuyu Tang is the primary treatment. If caused by Wind, add Wind-expelling herbs; if by Cold, add Warmth-providing herbs; if by Summerheat-Dampness, add Cooling and Drying herbs; if by Dryness-Heat, add Clearing and Moistening herbs. When dealing with climatic cycles, medication must follow the principles of these cycles. Furthermore, for Shaoyang headache, where pulses around the ears surge with heat, bloodletting should be performed. Therefore, my family's secret method for treating headache does not strictly follow meridian points but needles directly at the site of pain, reducing pain without necessarily bleeding. This follows the principle of *Xuanqi Fang*.

**Xuanqi Decoction**: Fangfeng (Saposhnikoviae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma).
For severe Wind, double Jingjie and Fangfeng; for Cold, remove Huangqin, add Chuanxiong and Xixin; for Summerheat, add Shigao and Xiangru; for Dampness, add Cangzhu and Baizhi; for Dryness, add Zhimu and Shigao; for Fire, add Huanglian and Zhizi.

**Qingzhen Decoction**: Shengma (Cimicifugae Rhizoma), Cangzhu (Atractylodis Rhizoma), Genge (Puerariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Xianheyeye (Nelumbinis Folium).
For Wind, add Fangfeng and Jingjie; for Cold, add Chuanxiong and Xixin; for Summerheat, add Huanglian and Shigao; for Dampness, add Baizhi; for Dryness, add Zhimu and Shigao; for excess Fire, add Zhizi and Huanglian.

**Shigao San**: Shigao (Gypsum Fibrosum), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baizhi (Angelicae Dahuricae Radix), Gegen (Puerariae Radix).
Grind into fine powder.

**Qingkong Gao**: Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma), Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix).
For Wind, add Jingjie, double Fangfeng; for Cold, remove Huangqin and Huanglian, add Shengjiang and Xixin; for Summerheat, add Shigao and Huanglian; for Dampness, add Cangzhu and Baizhi; for Dryness, add Zhimu and Shigao; for excess Fire, add Zhizi and Huanglian.

**Duhuo Xixin Tang**: Duhuo (Angelicae Pubescentis Radix), Xixin (Asari Radix et Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma), Qinjiao (Gentianae Macrophyllae Radix), Shengdi (Rehmanniae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Gancao (Glycyrrhizae Radix et Rhizoma).
For Wind, add Jingjie, double Fangfeng; for Cold, add Mahuang and Guizhi; for Summerheat, add Huangqin and Shigao; for Dampness, add Cangzhu and Baizhi; for Dryness, add Shigao and Zhuye; for excess Fire, add Zhimu and Huangbai.

**Cangzhu Chushi Tang**: Cangzhu (Atractylodis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Houpo (Magnoliae Officinalis Cortex), Fuling (Poria), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma), Banxiaqu (Pinelliae Fermentatum).
For Wind, add Fangfeng; for Cold, add Shengjiang; for Summerheat, add Huangqin; for Dampness, add Chuanxiong and Baizhi; for Dryness, add Zhimu and

**Wuzhuyu Tang**: Wuzhuyu (Evodiae Fructus), Renshen (Ginseng Radix et Rhizoma), Dazao (Zizyphi Fructus), Shengjiang (Zingiberis Rhizoma Recens).