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The head is the manifestation of Heaven, where the clear Yang Qi of the Six Fu Organs converges. The essence blood of the Five Zang Organs also gathers here. The pathogenic factors of the Six Excesses (Liu Yin) from the weather, and the rebellious influences of the Five Thieves (Wu Zei - pathogenic factors derived from the Five Elements) on human Qi, can all mutually harm. They may either obscure the clarity of the head or obstruct the meridians and collaterals, contending with the healthy Qi, leading to stagnation and heat generation, resulting in astringent pulses and pain. If pathogenic factors linger, causing fullness in the vessels and disorder of Qi and Blood, the pain becomes severe; this is excess pain. When invaded by Cold-Dampness and the True Qi is deficient, although there is no contention generating heat, the pathogen residing outside the vessels causes blood astringency and coldness in the vessels, leading to contraction and tension, pulling on small collaterals to cause pain; relief upon warmth indicates deficiency pain. Headache caused by Wind presents with twitching, pulling pain, and aversion to wind. Headache caused by Heat presents with vexation and aversion to heat. Headache caused by Dampness presents with heaviness in the head, worsening on cloudy days. Headache caused by Phlegm presents with dizziness, heaviness, and a sensation of nausea. Headache caused by Cold presents with contraction, aversion to cold, and shivering. Headache due to Qi deficiency presents with aversion to exertion; a large pulse indicates Qi deficiency headache, while a hollow (Kou) pulse indicates Blood deficiency headache. There are many causes for headache, yet ancient formulas often employ Wind-dispersing herbs because "above the high summit, only Wind can reach." Herbs with thin flavors belong to Yang within Yin and ascend from earth to heaven. For Wind-Cold-Dampness, these are indeed the primary treatment; even for deficiency and heat patterns, they are borrowed as guiding herbs.

Medical texts often divide headache and Tou Feng (Chronic Headache) into two categories, but it is one disease. Superficial and acute onset is named Headache; deep and chronic onset is named Tou Feng. Tou Feng inevitably affects the eyes; as the Classics state, "East Wind arises in Spring, damaging the Liver." The eyes are the orifices of the Liver; when Liver Wind moves, pathogens damage the orifices.

Long-standing headache that flares up upon slight exposure to Wind-Cold, requiring thick cotton wrapping for relief, belongs to Stagnant Heat. This is because the root is Heat while the branch is Cold. Due to underlying stagnant Heat, the pores are chronically open, allowing Wind-Cold to easily enter, causing internal heat to close and rebel, resulting in pain. Treatment requires purging fire and cooling blood, assisted by acrid-warm herbs to disperse the exterior.

Although Fire syndromes can occur in any meridian regarding headache, the Yangming meridian is the most severe. This is because Yangming Stomach Fire flourishes in the head and face, reaching directly to the Touwei point (ST8), so the pain must be severe, the pulse must be洪 (Hóng - Surging), and there is often internal heat and thirst. If there is throbbing pain in the head and neck without any exterior pathogen signs in the pulse, it must be Fire pathogen. Use Baihu Tang (White Tiger Decoction) plus Shengdi Huang (Rehmanniae Radix), Maidong (Ophiopogonis Radix), Mutong (Akebiae Caulis), and Zexie (Alismatis Rhizoma). For other meridians, select Shaoyao (Paeoniae Radix), Huafen (Trichosanthis Radix), Huangqin (Scutellariae Radix), Lianzi (Corydalis Rhizoma/Zhizi depending on context, likely Huanglian here given pairing), Zhimu (Anemarrhenae Rhizoma), Longdan Cao (Gentianae Radix), and Zhizi (Gardeniae Fructus) as appropriate. However, treating Fire should not assist with ascending and dispersing methods. Fire from external pathogens can be dispersed and removed; Fire from internal stagnation will become more intense if ascended.