赵 右偏头痛。鼻窍流涕。仍不通爽。咽喉疳腐。寤醒肢冷汗出。外邪头风。已留数月。其邪混处。
精华气血。咸为蒙闭。岂是发散清寒可解。头巅药铒。务宜清扬。当刺风池风府。投药仍以通
法。苟非气血周行。焉望却除宿病。(暑热上蒙清窍)
西瓜衣 鲜芦根 苡仁 通草 煎送腊矾丸。
何(四一)右偏风头痛。从牙龈起。(木火上炎)
炒生地(三钱) 蔓荆子(炒一钱) 黄甘菊(一钱) 茯苓(一钱半) 炒杞子(二钱)
冬桑叶(一钱) 炒丹皮(一钱) 川斛(一钱半)
王(五一)中年阴中之阳已虚。内风偏头痛。冷泪出。(阴中阳虚)还少丹。
徐(四一)头风既愈。复发。痛甚呕吐不已。阳明胃虚。肝阳化风愈动。恐有失明之忧。(胃虚风阳上逆)
炒半夏 茯苓 苦丁茶 菊花炭 炒杞子 柏子霜
朱(五四)阳明脉弦大而坚。厥阴脉小弦数促。面赤。头痛绕及脑后。惊惕肉 。 汗出。 早晨小
安。入暮偏剧。此操持怫郁。肝阳挟持内风。直上巅顶。木火戕胃为呕逆。阳越为面赤汗淋。内
因之病。加以司候春深。虑有暴厥 痉之幻。夫肝为刚脏。胃属阳土。姑议柔缓之法。冀有阳
和风熄之理。复脉去参姜桂加鸡子黄白芍。
王 始用茶调散得效。今宜养血和血。
川芎 归身 白芍(酒炒) 白蒺藜(炒) 桑枝
朱(三四)头风目痛昏赤。火风上郁最多。及询病有三四年。遇风冷为甚。其卫阳清气。久而损伤。非
徒清散可愈。从治风先治血意。
杞子 归身 炒白芍 沙苑 菊花 钩藤
头风一症。有偏正之分。偏者主乎少阳。而风淫火郁为多。前人立法。以柴胡为要药。其补
泻之间。不离于此。无如与之阴虚火浮。气升吸短者。则厥脱之萌。由是而来矣。先生则另
出心裁。以桑叶丹皮山栀荷叶边。轻清凉泄。使少阳郁遏之邪。亦可倏然而解。倘久则伤
及肝阴。参入咸凉柔镇可也。所云正者。病情不一。有气虚血虚。痰厥肾厥。阴伤阳浮。火亢
邪风之不同。按经设治。自古分晰甚明。兹不再述。至于肝阴久耗。内风日旋。厥阳无一息
之宁。痛掣之势已极。此时岂区区汤散可解。计惟与复脉之纯甘壮水。 胶黄之柔婉以
熄风和阳。俾刚亢之威。一时顿熄。予用之屡效如神。决不以虚谀为助。(邵新甫)
赵先生,右侧偏头痛。鼻窍流涕,仍然不通畅清爽。咽喉部有疳疮腐烂。睡眠醒来时四肢发冷、出汗。这是外邪引起的头风,已经持续了几个月。邪气混杂在精华气血之中,都被蒙蔽闭塞。这哪里是发散清寒的方法所能解决的?头部用药务必宜用轻清上扬之品。应当针刺风池穴和风府穴,用药仍以通利法为主。如果不是让气血周流运行,怎么能希望去除宿疾呢?(暑热上蒙清窍)
西瓜衣、鲜芦根、薏苡仁、通草,煎汤送服腊矾丸。
何先生(41岁),右侧偏风头痛,从牙龈处发起。(木火上炎)
炒生地(三钱)、蔓荆子(炒一钱)、黄甘菊(一钱)、茯苓(一钱半)、炒枸杞子(二钱)、冬桑叶(一钱)、炒丹皮(一钱)、川石斛(一钱半)。
王先生(51岁),中年时期阴中之阳已虚。内风引起的偏头痛,流出冷泪。(阴中阳虚)还少丹。
徐先生(41岁),头风病虽然痊愈,但复发。疼痛剧烈,呕吐不止。阳明胃气虚弱,肝阳化风更加妄动,恐怕有失明的忧虑。(胃虚风阳上逆)
炒半夏、茯苓、苦丁茶、菊花炭、炒枸杞子、柏子霜。
朱先生(54岁),阳明脉弦大而坚,厥阴脉小弦数促。面色红赤,头痛放射至脑后,惊惕不安,肌肉跳动,出汗。早晨症状稍安,入夜后偏重加剧。这是因为操劳持守导致怫郁,肝阳挟持内风,直冲巅顶,木火克伐胃腑导致呕逆,阳气外越导致面赤汗淋。这是内因导致的疾病,又加上时令正值春深,担心会有暴厥或痉病的变幻。肝是刚脏,胃属阳土。暂且议定柔缓的方法,期望达到阳和风熄的效果。复脉汤去掉人参、生姜、肉桂,加入鸡蛋黄和白芍。
王先生,起初使用茶调散得到疗效,现在适宜养血和血。
川芎、当归身、白芍(酒炒)、白蒺藜(炒)、桑枝。
朱先生(34岁),头风伴目痛昏赤,火风上郁最多。询问得知患病已有三四年,遇风冷则加重。其卫阳清气,长久以来受到损伤,不仅仅是清散方法所能治愈的。遵循“治风先治血”的意思。
枸杞子、当归身、炒白芍、沙苑子、菊花、钩藤。
头风这一病症,有偏侧和正中的区别。偏侧者主要关乎少阳经,而风淫火郁的情况较多。前人立法,以柴胡为要药,其补泻之间,不离于此。无奈如果遇到阴虚火浮、气升吸短的患者,那么厥脱的萌芽,由此而来。先生则另出心裁,用桑叶、丹皮、山栀、荷叶边,轻清凉泄,使少阳郁遏之邪,也可以瞬间解除。如果日久则伤及肝阴,参入咸凉柔镇的药物即可。所谓正中者,病情不一,有气虚血虚、痰厥肾厥、阴伤阳浮、火亢邪风的不同。按照经络设立治疗方法,自古分晰得很清楚,这里不再赘述。至于肝阴长久耗损,内风每日旋转,厥阳没有片刻安宁,疼痛掣动的势头已到极点,此时难道区区汤剂散剂所能解决?考虑唯有给予复脉汤的纯甘壮水,阿胶、鸡子黄的柔婉来熄风和阳。使得刚亢的威力,一时顿熄。我使用这种方法屡效如神,决不以虚假谄媚来助长名声。(邵新甫评注)
Mr. Zhao, right-sided migraine. Nasal discharge from the nasal orifices, still not clear and unobstructed. Gangrene-like ulceration in the throat. Upon waking from sleep, limbs are cold with sweating. This is external pathogenic factor-induced head wind (Tou Feng), which has persisted for several months. The pathogen is mixed within the essence, qi, and blood, all of which are covered and closed off. How can this be resolved by dispersing and clearing cold methods? Medications for the head must be light, clear, and ascending. Acupuncture at Fengchi (GB20) and Fengfu (GV16) should be performed, and medication should still employ the method of unblocking. Unless the circulation of qi and blood is restored, how can one hope to eliminate chronic diseases? (Summer-heat turbidity covering the clear orifices)
Watermelon rind (Xigua Yi), fresh reed rhizome (Xian Lugen), Coix seed (Yiren), Taro stem (Tongcao), decocted to administer La Fan Wan (Wax Alum Pill).
Mr. He (41 years old), right-sided wind-induced headache, originating from the gums. (Wood fire flaming upward)
Fried Rehmannia root (Chao Shengdi, 3 qian), Vitex fruit (Man Jing Zi, fried, 1 qian), Yellow Chrysanthemum flower (Huang Gan Ju, 1 qian), Poria (Fuling, 1.5 qian), Fried Goji berry (Chao Qizi, 2 qian), Winter Mulberry leaf (Dong Sangye, 1 qian), Fried Moutan bark (Chao Danpi, 1 qian), Dendrobium stem (Chuan Hu, 1.5 qian).
Mr. Wang (51 years old), in middle age, the yang within yin is already deficient. Internal wind-induced migraine, with cold tears flowing. (Deficiency of yang within yin) Huan Shao Dan (Return to Youth Pill).
Mr. Xu (41 years old), head wind recovered but relapsed. Severe pain with incessant vomiting. Yangming stomach deficiency, liver yang transforming into wind moving more violently, fearing the risk of blindness. (Stomach deficiency with rebellious wind and yang)
Fried Pinellia tuber (Chao Banxia), Poria (Fuling), Kuding tea (Kuding Cha), Charred Chrysanthemum flower (Juhua Tan), Fried Goji berry (Chao Qizi), Thuja seed powder (Baizi Shuang).
Mr. Zhu (54 years old), Yangming pulse is wiry, large, and firm; Jueyin pulse is small, wiry, rapid, and hurried. Red face, headache radiating to the back of the head, fright and tremors, muscle twitching, sweating. Symptoms are slightly calm in the morning, worsening significantly at night. This is due to labor and restraint causing stagnation, liver yang carrying internal wind directly to the vertex. Wood-fire damaging the stomach leads to vomiting and rebellion; yang escaping leads to red face and profuse sweating. This is an internal cause disease, compounded by the seasonal timing of deep spring, raising concern for sudden syncope or convulsions. The liver is a rigid organ; the stomach belongs to yang earth. Tentatively propose a softening and soothing method, hoping for the resolution of yang and extinguishing of wind. Mai Mai Jing Tong Tang (Pulse Restoring Decoction) without Ginseng, Ginger, and Cinnamon Twig, adding Egg Yolk and White Peony Root (Bai Shao).
Mr. Wang, initially used Cha Tiao San (Tea-Powder Powder) with effect. Now suitable for nourishing and harmonizing blood.
Sichuan Lovage Rhizome (Chuanxiong), Angelica sinensis root body (Guishen), White Peony Root (Baishao, wine-fried), Tribulus fruit (Bajili, fried), Mulberry twig (Sangzhi).
Mr. Zhu (34 years old), head wind with eye pain, dimness, and redness. Fire-wind upward depression is most prevalent. Inquiry reveals illness for three to four years, worsening with wind-cold. His defensive yang and clear qi have been damaged over time; it cannot be cured merely by clearing and dispersing. Following the principle that "treating wind requires first treating blood."
Goji berry (Qizi), Angelica sinensis root body (Guishen), Fried White Peony Root (Chao Baishao), Astragalus complanatus seed (Shayuan), Chrysanthemum flower (Juhua), Uncaria hook (Gouteng).
The syndrome of head wind has distinctions between lateral and central types. Lateral types primarily involve the Shaoyang channel, where wind hyperactivity and fire depression are common. Predecessors' legislation prioritized Bupleurum root (Chaihu); its tonification and purgation revolve around this. However, if applied to patients with yin deficiency and floating fire, or rising qi and short breathing, the onset of collapse may arise. Mr. Ye employed original ingenuity, using Mulberry leaf, Moutan bark, Gardenia, and Lotus leaf edge, which are light, cool, and draining, allowing the depressed pathogens of Shaoyang to resolve instantly. If prolonged, it damages liver yin; thus, salty-cool and softening/astringent herbs should be added. As for central types, conditions vary: there are qi deficiency, blood deficiency, phlegm syncope, kidney syncope, yin injury with floating yang, and hyperactive fire with pathogenic wind. Treatment based on meridians has been clearly distinguished since ancient times, so it is not repeated here. Regarding long-term consumption of liver yin, with daily rotation of internal wind, and jueyang having no moment of peace, the intensity of painful pulling is extreme. At this time, how can simple decoctions or powders suffice? It is calculated that only Pure Sweet Water-Nourishing methods of Mai Mai Jing Tong Tang, and the gentle softening of Donkey-hide Gelatin (Ejiao) and Egg Yolk (Jihuang) can extinguish wind and harmonize yang, causing the rigid and hyperactive force to subside instantly. I have used this method with frequent miraculous efficacy, and certainly do not resort to false flattery. (Commentary by Shao Xinpu)