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The head, symbolizing heaven, is the convergence point for the clear yang qi of the six fu-organs and the essence blood of the five zang-organs. However, the pathogenic factors of the Six Excesses (Liu Yin) arising from heavenly weather, and the rebellious Qi of the Five Thieves (Wu Zei) resulting from human constitution, can all mutually harm each other. They either obscure and cover the clarity of the head, or cause stasis and blockage in the meridians, thereby clashing with the true Qi to produce pain. Headache caused by Wind is characterized by twitching and pulling pain, aversion to wind, sweating, and pain. Headache caused by Summer-heat and Heat may present with or without sweating, but always involves aversion to heat and pain. Headache caused by Dampness presents with pain and a heavy sensation in the head, worsening on cloudy days. Headache caused by Phlegm-Fluids also presents with dizziness, heaviness, and pain, accompanied by a sense of mental cloudiness and nausea. Headache caused by Cold involves aversion to cold and a deep, slow, and tight pulse. Headache due to Qi Deficiency worsens with exertion and presents with a large pulse. Headache due to Blood Deficiency is associated with palpitations and fright, presenting with a knotted (Kou) pulse.

Li Dongyuan generally treated headaches using Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), and Phellodendri Cortex (Huangbai) processed with wine, combined with wind-dispelling agents, such as Qingkong Gao (Clear Sky Paste), Anshen San (Calm Spirit Powder), and Qingshang Xiehuo Tang (Clear Upper and Drain Fire Decoction). However, he indiscriminately used herbs like Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), Gaoben (Ligustici Rhizoma et Radix), and Manjingzi (Vittagiae Fructus), which lacked strict discipline. Students may learn from his intent. The Chatiao San (Tea-Powder Powder) from *Yuanyu* is concise and practical.

For chronic headache due to Head Wind, it is necessary to add small amounts of Chuanxiong Rhizome (Chuanxiong), Angelicae Sinensis Radix (Danggui), and Carthami Flos (Honghua). This is not only to treat wind but also to harmonize blood and relieve pain. Fine tea is best at clearing upper wind-heat; using it as a guiding herb for chronic pain is excellent. Li Dongyuan and Zhang Qianfu often used it.

Xu Shuci's Jingjie San uses solely Jingjie (Schizonepetae Spica) to treat wind and Shigao (Gypsum Fibrosum) to treat heat, which is extremely concise. Li Dongyuan's Qingkong Gao and other formulas seem to have derived their intent from this and expanded upon it.

Headache due to Wind-Phlegm is often accompanied by vomiting, regurgitation, and vertigo. If wind-dispelling drugs are used, the phlegm will rise further, and the pain will intensify. Yuhu Wan (Jade Pot Pill) from *Heji Jufang* is the specific remedy. Li Dongyuan transformed it into Baizhu Banxia Tianma Tang (Atractylodis Macrocephalae, Pinellia, and Gastrodia Decoction), which addresses Qi Deficiency as well.

Kidney-Jue Headache and Liver-Jue Headache are discussed in greatest detail in *Ben Shi Fang*.

Yuzhen Wan contains Sulfur and Pinelliae Rhizoma (Banxia), possessing great warming and descending power; Shigao (Gypsum Fibrosum) and Xiaoshi (Natrii Sulfas) possess strong cold-draining capabilities. When Yin Qi rebels upward, its onset is most sudden. Treating it with purely Yang drugs will likely cause rejection (Ge Ju); therefore, Shigao and Xiaoshi must serve as assistants to ensure mutual integration without conflict. Heixi Dan (Black Pellet Pill) also reflects this principle.

Rongzhu Dan has two formulas: one uses Cinnabar (Zhusha) and Deer Antler Glue (Lurong) made into pills, reflecting the idea of tonifying deficiency and anchoring floating Yang. The other uses Cinnabar (Zhusha) together with Aconiti Lateralis Radix Preparata (Caowu), Impatiens Herba (Qumai), and Dioscoreae Hypoglaucae Rhizoma (Huangyaozi) roasted in fire, taking only the Cinnabar powder to make pills. Not only is Cinnabar toxic when roasted, but even the acrid dispersing nature of Caowu and the bitter-descending nature of Qumai and Huangyaozi become ash after roasting and are blown away and unused. How can they still be expected to assist each other?

Various nasal insufflation formulas for headache use solely acrid-warm herbs in *Ben Shi Fang*, while Li Dongyuan and Liu Hejian use both acrid-cool herbs. Long-standing accumulated wind tends to transform into heat, whereas obstructed Qi requires warmth to unblock. One must weigh the condition and adjust the dosage accordingly; this is the responsibility of the wise practitioner.

Toubing Bingzi (Headache Cake) includes recipes using Wubeizi (Galla Chinensis), Quanxie (Scorpio), and Tougou (Gecko) mixed with vinegar; or Tiantanxing (Arisaematis Rhizoma) and Chuanxiong Rhizome (Chuanxiong) mixed with scallion white and pounded into a cake; or Ricini Semen (Bimazi) and Frankincense (Ruxiang); or Rhei Radix et Rhizoma (Dahuang) and Mirabilite (Mangxiao) mixed with mud from the bottom of a well for external application. However, for external treatments, regardless of whether the pathogen is cold or heat, acrid-warm herbs should be used to open and unblock. Using purely bitter-cold herbs will exacerbate obstruction. Unless the heat is extreme, they should not be used lightly.

The causes of headache are manifold: Wind, Cold, Dampness, Heat, and combined Qi disharmony. Combined Qi disharmony, such as Fire combining with Dampness, is described in *Neijing*: "When Shaoyang governs the year... during the second Qi, heat stagnates in the upper part, causing headache, vomiting, and mental confusion." There is also Fire excess leading to Water retaliation: "When Metal of the year is insufficient,炎火 (blazing fire) prevails; retaliation brings Yin rebellion, and Yang is repelled and rises upward, causing pain in the head and extending to the vertex, with fever." There is Stomach Excess: "Headache and tinnitus, dysfunction of the nine orifices, arise from the stomach and intestines." There is Kidney Jue: "Headache and cephalic diseases, with deficiency below and excess above, involve the Foot Shaoyin and Foot Taiyang meridians; severe cases enter the Kidney." There is Heart Heat: "Mental restlessness and headache, the disease is in the diaphragm, involving the Hand Taiyang and Hand Shaoyin meridians." There is Phlegm-Fluids: The disease is in the Spleen; Li Dongyuan calls it Taiyin Phlegm-Jue, with headache, blurred vision, vomiting, and confusion, also due to Dampness excess. There is Internal Wind: Wind transforms from Fire, the disease is in the Liver; not only do the Jueyin meridian and Du meridian converge at the vertex, but the rebellious Qi of the Liver itself can also ascend to the vertex. Furthermore, if True Qi fails to remain secure and rebels upward, causing severe pain in the Tianmen (forehead) radiating to the Ninwan (brain), it is called True Headache (Zhen Toutong), which is mostly incurable. Ancient formulas state: Administer Heixi Dan, moxa Baihui (GV20), and vigorously administer Ginseng Radix et Rhizoma (Renshen), Aconiti Lateralis Radix Preparata (Fuzi), Aconitum carmichaelii Debx. (Wutou), and Aquilariae Lignum Resinatum (Chenxiang); there may be a chance of survival. However, if the Tianzhu (neck/spine) collapses, little can be done.