（附脑痛、眉骨痛）
【脉】 寸脉紧急或短，皆曰头痛，又浮而滑为风痰，主头目痛，脉反短涩者死
。又卒然无
所见者死；脑痛、脉缓大者死。太阳头痛，脉浮紧，恶风寒。少阳头痛，脉弦细，有寒热。
阳明头痛，脉浮缓长，自汗。太阴头痛，脉沉缓，必有痰。厥阴头痛，脉浮缓，为冷厥。少
阴头痛，脉沉细，为寒厥。左属风，右属痰。
【因】 有风、有痰者，多风痰结滞。痛甚者，火多，火曰炎上。血虚头痛者，
亦多血不上荣。诸经气滞亦头痛，乃经气聚而不行也。
【证治】 太阳头痛兼项痛，足太阳所过攒竹痛也，恶风寒，羌活、川芎主之。
阳明头痛，
自汗发热，石膏、白芷、葛根、升麻主之。少阳头痛，额角上偏痛，往来寒热，柴、芩主之
。太阴头痛，有湿痰实，体重腹痛，半夏、南星、苍术主之。少阴头痛，主三阴、三阳经不
流行，而足寒逆为寒厥，细辛主之。厥阴头痛顶痛，血不及，或痰吐涎沫、厥冷，吴茱萸主
之。气虚头痛，黄 主之。病则耳鸣，九窍不和，参、 主之。血虚头痛，芎、归主之。伤
寒头痛，从伤寒法治之。太阳证，麻黄汤、桂枝汤；阳明脉洪，白虎；少阳柴胡；太阴脉浮
则桂枝，脉沉则理中；少阴麻黄加辛、附子；厥阴桂枝麻黄各半汤。痰厥头痛，吐之。火作
痛，清之、散之。伤暑亦同。湿热头痛，证则心内烦。外有香港脚，亦能头痛，其状吐逆、寒
热、便溲不通。有谷疸亦头痛。
半夏白术天麻汤 治痰厥头痛。
天麻（五分） 木香（一钱） 半夏（七钱半） 黄 （五分） 苍术 陈皮（各半钱） 人参
泽泻（各一钱） 神曲（一钱，炒） 干姜 黄柏（二钱） 茯苓（五分）
清空膏 治风、湿、热及诸般头痛，惟血虚不治。
羌活 黄连（酒制） 防风（各一钱） 柴胡（七钱） 川芎（五钱） 甘草（一钱半） 黄芩（
三钱）
白汤调下。巅顶痛，加蔓荆子、 本。
芎归汤 治血虚自鱼尾上攻。
茶调散 吐、头痛有痰。
家珍方 治偏头痛连睛痛。
石膏 黍粘子（炒）
为末，酒下。
玉壶丸 治风湿头痛，亦治痰患。
雄黄 白术 南星 半夏 天麻
香芎散 治一切头风。
香附（二两，炒去毛） 川芎 甘草（一两，炙） 石膏（半两） 细辛 防风 草乌 川乌
白芷 荆芥 羌活
煎。
诸头痛有六证
伤风头痛，或半边偏痛，皆因冷风所吹，遇风冷则发，脉寸浮者是也。
食积，因胃中有阴冷，宿食不化，上冲头痛，右手脉浮紧甚者是也。
气虚，因下部气虚，上攻，温温而痛者，异乎邪毒所攻，无邪，脉尺虚浮是也。
伤寒在太阳经，其痛如破，关前脉数是也，紧数是也。阳明经胃热上攻，右关洪大而数
是也。
膈上有风涎冷痰，而或呕吐，脉弦细，出于寸口是也。
阴毒伤寒，身不热，脉沉细，目痛，皆血有太过不及，皆能为痛。太过则目壅塞而发痛
，不
及则无血养而枯痛。目之锐 ，少阳经也，血少气多。目之上纲 ，太阳经也，血多气少。
目之下纲，阳明经也，血气俱多。唯足厥阴连于目系而已。血太过者，血得太热而溢于上，
所以作痛。治法，血实者决之，虚者补之。宜以辛散之，凉以清之、汗之、吐之。
脑痛，乃风热乘虚而入于脑，以辛凉之药散之、行之。眉骨痛乃风痰。
羌活汤 治风热壅盛，上攻头目，昏眩疼痛及脑疼。
羌活 防风 黄芩（酒炒，一两） 黄连（一两，酒制） 柴胡（七钱） 黄柏（酒炒） 栝蒌
根（酒制） 甘草 茯苓（各半两） 泽泻（三钱）
羌附汤 治冬大寒犯脑痛，齿亦痛，名曰脑风。
麻黄 黑附 升麻 防风 白僵蚕 黄柏（三钱） 羌活 苍术（各五分） 甘草 白芷
黄（一钱）
作一服。
眉骨痛方 羌活 防风 甘草 黄芩（酒炒） 白术 半夏 南星 细辛
又方 加乌头、草乌，童便炒去毒为君
藿香散 治脑风头痛。
藿香 川芎 天麻 蔓荆子 槐花 白芷
酒调下
吹搐方 治同上。
谷精草 铜绿（各二钱，另） 硝石（一钱，另研，吹鼻中。） 细辛 瓜蒂 良姜（各一
钱） 硝（五钱）
含水满口，以药搐鼻。
荆芥 薄荷 木贼 僵蚕 蝎梢
茶清下二钱。
风成寒中则泣出。风气与阳明入胃，循脉而上至目内 ，人瘦则外泄而泣，宜辛温。
风成热则目黄。风气与阳明入胃，循脉而上至目内 ，人肥不得外泄，故热郁也。
(Attached: Brain pain, eyebrow bone pain)
[Pulse]
If the pulse at the Cun position is tight or short, it is all termed headache. If the pulse is floating and slippery, it indicates wind-phlegm, primarily manifesting as head and eye pain. If the pulse is unexpectedly short and choppy, the prognosis is fatal. Sudden loss of vision is also a sign of death; brain pain accompanied by a slow and large pulse indicates death. Taiyang headache presents with a floating and tight pulse, aversion to wind and cold. Shaoyang headache presents with a wiry and thin pulse, accompanied by alternating chills and fever. Yangming headache presents with a floating, slow, and long pulse, accompanied by spontaneous sweating. Taiyin headache presents with a deep and slow pulse, indicating the presence of phlegm-dampness. Jueyin headache presents with a floating and slow pulse, indicating cold jue (reversal). Shaoyin headache presents with a deep and thin pulse, indicating cold jue. Headache on the left side is mostly due to wind, while headache on the right side is mostly due to phlegm turbidity.
[Etiology]
Cases involving wind and phlegm are often due to wind-phlegm stagnation. Severe pain is often caused by fire, as fire has a tendency to flare upwards. Headache due to blood deficiency is often because blood fails to ascend and nourish the head. Qi stagnation in the meridians can also cause headache, which occurs when meridian qi gathers but fails to circulate.
[Syndrome Differentiation and Treatment]
Taiyang headache, accompanied by neck pain, involves pain at the Zanzhu acupoint (Cuanzhu, BL2), where the Foot-Taiyang Bladder Meridian passes, accompanied by aversion to wind and cold. It is treated mainly with Qianghuo (Notopterygii Rhizoma et Radix) and Chuanxiong (Chuanxiong Rhizoma).
Yangming headache, accompanied by spontaneous sweating and fever, is treated mainly with Shigao (Gypsum Fibrosum), Baizhi (Angelicae Dahuricae Radix), Gegen (Puerariae Lobatae Radix), and Shengma (Cimicifugae Rhizoma).
Shaoyang headache, characterized by unilateral pain at the temple, accompanied by alternating chills and fever, is treated mainly with Chaihu (Bupleuri Radix) and Huangqin (Scutellariae Radix).
Taiyin headache, characterized by damp-phlegm excess syndrome, heavy body, and abdominal pain, is treated mainly with Banxia (Pinelliae Tuber), Nanxing (Arisaematis Rhizoma Preparatum), and Cangzhu (Atractylodis Rhizoma).
Shaoyin headache is mainly due to the non-circulation of Qi in the Three Yin and Three Yang meridians, leading to cold extremities and reversal (cold jue), treated mainly with Xixin (Asari Radix et Rhizoma).
Jueyin headache, characterized by vertex pain, insufficient blood supply, or expectoration of saliva and foam with cold limbs, is treated mainly with Wuzhuyu (Evodiae Fructus).
Qi deficiency headache is treated mainly with Renshen (Ginseng Radix) and Huangqi (Astragali Radix). *Note: Original text says "Huang", context implies Huangqi.*
When disease causes tinnitus and disharmony of the nine orifices, it is treated mainly with Renshen and Huangqi.
Blood deficiency headache is treated mainly with Chuanxiong and Danggui (Angelicae Sinensis Radix).
Headache due to Cold Damage (Shanghan) is treated according to Shanghan methods.
For Taiyang syndrome, Mahuang Tang (Ephedra Decoction) or Guizhi Tang (Cinnamon Twig Decoction); for Yangming with a surging pulse, Baihu Tang (White Tiger Decoction); for Shaoyang, Chaihu Tang (Bupleurum Decoction); for Taiyin, if the pulse is floating, use Guizhi Tang; if deep, use Lizhong Tang (Regulate the Middle Decoction); for Shaoyin, Mahuang combined with Xixin and Fuzi (Prepared Aconite Root); for Jueyin, Guizhi Mahuang Half-Decoction (Guizhi Mahuang Ge Ban Tang).
Phlegm-jue headache is treated with emesis.
Pain caused by fire is treated with clearing and dispersing methods. Heatstroke-induced headache is treated similarly.
Damp-heat headache manifests with internal restlessness. External gout (Hongjiao) can also cause headache, presenting with vomiting, alternating chills and fever, and obstruction of urination and defecation. Grain jaundice (Gudan) can also cause headache.
Banxia Baizhu Tianma Tang (Pinellia, Atractylodes Macrocephala, and Gastrodia Decoction): Treats phlegm-jue headache.
Ingredients: Tianma (Gastrodiae Rhizoma, 5 fen), Muxiang (Aucklandiae Radix, 1 qian), Banxia (Pinelliae Tuber, 7.5 qian), Huangqi (Astragali Radix, 5 fen), Cangzhu (Atractylodis Rhizoma), Chenpi (Citri Reticulatae Pericarpium, 0.5 qian each), Renshen (Ginseng Radix), Zexie (Alismatis Rhizoma, 1 qian each), Shenqu (Massa Medicata Fermentata, 1 qian, stir-fried), Ganjiang (Zingiberis Rhizoma), Huangbai (Phellodendri Cortex, 2 qian), Fuling (Poria, 5 fen).
Qingkong Gao (Clearing the Cavity Ointment): Treats headaches due to wind, dampness, heat, and various other types, except those due to blood deficiency.
Ingredients: Qianghuo (Notopterygii Rhizoma et Radix), Huanglian (Coptidis Rhizoma, wine-processed, 1 qian each), Fangfeng (Saposhnikoviae Radix, 1 qian), Chaihu (Bupleuri Radix, 7 qian), Chuanxiong (Chuanxiong Rhizoma, 5 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 1.5 qian), Huangqin (Scutellariae Radix, 3 qian).
Take with warm water. For vertex pain, add Manjingzi (Viticis Semen) and Gaoben (Ligustici Chuanxiongzhong Rhizoma).
Xiong Gui Tang (Chuanxiong and Danggui Decoction): Treats blood deficiency headache, where pain attacks upward from the outer corner of the eye.
Cha Tiao San (Tea-Powder for Harmonizing): Treats vomiting and headache with phlegm.
Jiazhen Fang (Family Treasure Formula): Treats migraines extending to eye pain.
Ingredients: Shigao (Gypsum Fibrosum), Shunianzi (Arctii Fructus, stir-fried).
Grind into powder, take with wine.
Yuhu Wan (Jade Pot Pill): Treats wind-damp headache and also phlegm disorders.
Ingredients: Xionghuang (Realgar), Baizhu (Atractylodis Macrocephalae Rhizoma), Nanxing (Arisaematis Rhizoma Preparatum), Banxia (Pinelliae Tuber), Tianma (Gastrodiae Rhizoma).
Xiang Xiong San (Cyperi and Chuanxiong Powder): Treats all types of head wind.
Ingredients: Xiangfu (Cyperi Rhizoma, 2 liang, stir-fried and de-husked), Chuanxiong (Chuanxiong Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang, honey-fried), Shigao (Gypsum Fibrosum, 0.5 liang), Xixin (Asari Radix et Rhizoma), Fangfeng (Saposhnikoviae Radix), Caowu (Aconiti Kusnezoffii Radix), Chuannwu (Aconiti Carmerichanii Radix), Baizhi (Angelicae Dahuricae Radix), Jingjie (Schizonepetae Spica), Qianghuo (Notopterygii Rhizoma et Radix).
Decoct and take.
Six Types of Headaches:
Wind-cold headache, or unilateral pain, is caused by cold wind blowing; it occurs upon exposure to cold wind, with a floating pulse at the Cun position.
Food stagnation headache is caused by cold yin in the stomach and undigested food rushing upward; it presents with a very tight and floating pulse on the right hand.
Qi deficiency headache is caused by lower jiao qi deficiency rushing upward, causing dull pain, distinct from pathogenic toxin attack; there is no excess pathogen, and the pulse at the Chi position is deficient and floating.
Shanghan in the Taiyang meridian causes severe pain like breaking; this is indicated by a rapid pulse anterior to the Guan position, or a tight and rapid pulse.
Yangming meridian stomach heat rushing upward is indicated by a surging and rapid pulse at the right Guan position.
Wind-phlegm and cold phlegm above the diaphragm, causing occasional vomiting, present with a wiry and thin pulse emerging from the Cun position.
Yin-toxin Shanghan presents with no fever, a deep and thin pulse, and eye pain. Both excess and deficiency of blood can cause pain. Excess leads to ocular congestion and pain; deficiency leads to lack of blood nourishment and dry pain. The outer canthus belongs to the Shaoyang meridian, with less blood and more qi. The upper eyelid margin belongs to the Taiyang meridian, with more blood and less qi. The lower eyelid margin belongs to the Yangming meridian, with abundant blood and qi. Only the Foot-Jueyin Liver Meridian connects to the eye system. When blood is in excess, it becomes too hot and overflows upward, causing pain. Treatment: Drain excess blood, tonify deficient blood. Use pungent herbs to disperse, cool herbs to clear, induce sweating, or induce vomiting.
Brain pain is caused by wind-heat entering the brain through deficiency; treat with pungent-cool herbs to disperse and promote circulation. Eyebrow bone pain is caused by wind-phlegm.
Qianghuo Tang (Notopterygium Decoction): Treats excessive wind-heat congesting and attacking the head and eyes, causing dizziness, pain, and brain pain.
Ingredients: Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Huangqin (Scutellariae Radix, wine-fried, 1 liang), Huanglian (Coptidis Rhizoma, wine-processed, 1 liang), Chaihu (Bupleuri Radix, 7 qian), Huangbai (Phellodendri Cortex, wine-fried), Gualougen (Trichosanthis Radix, wine-processed), Gancao (Glycyrrhizae Radix et Rhizoma), Fuling (Poria, 0.5 liang each), Zexie (Alismatis Rhizoma, 3 qian).
Qiang Fu Tang (Notopterygium and Aconite Decoction): Treats brain pain and toothache caused by severe winter cold invading the brain, named Brain Wind.
Ingredients: Mahuang (Ephedrae Herba), Heifu (Prepared Aconiti Lateralis Radix), Shengma (Cimicifugae Rhizoma), Fangfeng (Saposhnikoviae Radix), Baijiangcan (Bombyx Batryticatus), Huangbai (Phellodendri Cortex, 3 qian), Qianghuo (Notopterygii Rhizoma et Radix), Cangzhu (Atractylodis Rhizoma, 5 fen each), Gancao (Glycyrrhizae Radix et Rhizoma), Baizhi (Angelicae Dahuricae Radix), Huangqi (Astragali Radix, 1 qian).
Taken as one dose.
Eyebrow Bone Pain Formula: Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Huangqin (Scutellariae Radix, wine-fried), Baizhu (Atractylodis Macrocephalae Rhizoma), Banxia (Pinelliae Tuber), Nanxing (Arisaematis Rhizoma Preparatum), Xixin (Asari Radix et Rhizoma).
Alternative formula: Add Wutou (Aconiti Radix) and Caowu (Aconiti Kusnezoffii Radix), processed with child's urine to remove toxicity, used as the sovereign herb.
Huoxiang San (Agastache Powder): Treats brain wind headache.
Ingredients: Huoxiang (Agastachis Herba), Chuanxiong (Chuanxiong Rhizoma), Tianma (Gastrodiae Rhizoma), Manjingzi (Viticis Semen), Huaihua (Sophorae Flos), Baizhi (Angelicae Dahuricae Radix).
Take with wine.
Chui Chu Fang (Blowing and Twitching Formula): Treats the same as above.
Ingredients: Gujingcao (Essential Flower), Tonglv (Chalcitis, 2 qian each, prepared separately), Xiaoshi (Niter, 1 qian, ground separately, blown into nose), Xixin (Asari Radix et Rhizoma), Gudi (Momordicae Fructus), Liangjiang (Galangal Rhizoma, 1 qian each), Naosha (Sal Ammoniac, 5 qian).
Fill mouth with water, blow medicine into the nose.
Jingjie (Schizonepetae Spica), Bohe (Menthae Haplocalycis Herba), Muze (Equiseti Hiemalis Herba), Jiangcan (Bombyx Batryticatus), Xieshao (Scorpion tail).
Take 2 qian with tea infusion.
When wind turns cold, tears flow. Wind qi enters the stomach with the Yangming meridian, circulating up to the inner canthus. In thin people, it leaks externally causing tears; treat with pungent-warm herbs.
When wind turns hot, the eyes turn yellow. Wind qi enters the stomach with the Yangming meridian, circulating up to the inner canthus. In fat people, it cannot leak externally, causing heat stagnation.