头痛多主于痰，痛甚者火多。有可吐者，可下者。清空膏治诸头痛，除血虚头痛不
可治（出《东垣试效方》）。血虚头痛，自鱼尾上攻头痛，用芎归汤。古方有追涎药。
〔附录〕头痛须用川芎，如不愈，各加引经药。
太阳川芎，阳明白芷，少阳柴胡，太阴苍术，少阴细辛，厥阴吴茱萸。
如肥人头痛，是湿痰，宜半夏、苍术；如瘦人，是热，宜酒制黄芩、防风。如感冒头痛
防风、羌活、 本、白芷；如气虚头痛，宜黄 酒洗、生地黄、南星、秘藏安神汤；如风
在上头痛，宜天麻、蔓荆子、台芎、酒制黄芩；如苦头痛，用细辛；如形瘦苍黑之人头痛
，乃是血虚，宜当归、用芎、酒黄芩；如顶颠痛，宜 本、防风、柴胡。东垣云∶顶颠痛须
本，去川芎。且如太阳头痛，恶风，脉浮紧，川芎、羌活、独活、麻黄之类为主；少阳
，脉弦细，往来寒热，柴胡为主；阳明头痛，自汗，发热恶寒，脉浮缓长实，升麻、葛根、石膏
、白芷为主；太阴头痛，必有痰，体重或腹痛，脉沉缓，以苍术、半夏、南星为主；少阴
头痛，足寒气逆
，为寒厥，其脉沉细，麻黄、附子、细辛为主；厥阴头痛，或吐痰沫，厥冷，其脉浮缓，
吴茱萸汤主之，血虚头痛，当归、川芎为主；气虚头痛，人参、黄 为主；气血俱虚头痛，
调中益气汤内加川芎三分，蔓荆子三分，细辛二分，其效如神。又有痰厥头痛，所感不一
。是知方者验也，法者用也，徒知体而不知用者弊，体用不失，可谓上工矣。
附方
清空膏 治偏正头痛，年深不愈者。又治风湿热，头上壅，及脑痛，除血虚头痛不治。
川芎（五钱） 柴胡（七钱） 黄连（酒炒） 防风 羌活（各一两） 炙甘草（一两五钱） 细挺子黄芩
（三两，去皮，一半酒制，一半炒）
上为末，每服二钱，热盏内入茶少许，汤调如膏。抹在口内，临卧少用白汤送下。如苦
，每服加细辛二分；痰厥头痛，脉缓，减羌活、防风、川芎、甘草，加半夏一两五钱；如
正头痛，服之不愈，减羌活、防风、川芎一半，加柴胡一倍；如发热、恶热而渴，此阳明
头痛，只与白虎汤，加好吴白芷，
安神汤 治头痛，头旋眼黑。
生甘草 炙甘草（各二钱） 防风（二钱五分） 柴胡 升麻 酒生地黄 酒知母（各五钱） 酒柏
羌活（各一两） 黄 （二两）
上锉，每服五钱，水煎。加蔓荆子五分，川芎三分，
彻清膏
蔓荆子 细辛（各一分） 薄荷叶 川芎（各三分） 生甘草 炙甘草（各五分） 本（一钱）
上为末。茶清调下二钱。
顺气和中汤 治气虚头痛，此药升阳补气，头痛自愈。
黄 （一钱半）人参（一钱） 甘草（炙，七分） 白术 陈皮 当归 芍药（各五分） 升麻 柴胡
（各三分） 细辛 蔓荆子 川芎（各二分）
上作一服，水煎。食后服。
不卧散 治头痛。
猪牙皂角（一钱） 玄胡 青黛（些少）
上为末。吹鼻中取涎。
半夏白术天麻汤 治脾胃证，已经服疏风丸，下二三次，元证不瘳，增以吐逆，痰唾稠
粘，眼黑头旋，目不敢开，头苦痛如裂，四肢厥冷，不得安卧。
黄柏（二分，酒洗） 干姜（三分） 泽泻 白茯苓 天麻 黄 人参 苍术（各五分） 炒神曲
白术（各一钱） 麦芽 半夏（汤洗） 陈皮（各一钱半）
上每服五钱，水煎热服。
芎归汤 见肠风类。
调中益气汤 见脾胃类。
治头痛
片苓酒浸透，晒干为末，茶清调。治诸般头痛，亦治血虚头痛。
治头痛连眼痛 此风痰上攻，须用白芷开之。
雨前茶 川芎 白芷 防风 本 细辛 当归
治头痛如破
酒炒大黄半两，一半茶煎。
头痛多由痰邪引起，疼痛剧烈的多因火邪所致。有的患者适合用吐法治疗，有的适合用下法治疗。清空膏可以治疗各种类型的头痛，但血虚引起的头痛不适用（出自《东垣试效方》）。血虚引起的头痛，疼痛从眼角后方（鱼尾）向上攻冲至头部，使用芎归汤治疗。古方中有用于追逐涎沫的药物。
〔附录〕治疗头痛必须使用川芎，如果效果不显著，应根据经络加入相应的引经药。
太阳经头痛用川芎，阳明经头痛用白芷，少阳经头痛用柴胡，太阴经头痛用苍术，少阴经头痛用细辛，厥阴经头痛用吴茱萸。
如果是肥胖之人头痛，属于湿痰，适宜用半夏、苍术；如果是消瘦之人头痛，属于热证，适宜用酒制的黄芩、防风。如果是感冒引起的头痛，用防风、羌活、藁本、白芷；如果是气虚引起的头痛，适宜用人参（原文“黄”疑为“参”之误或脱字，结合后文及语境补为人参，或指黄芪，此处依常见配伍及后文“人参、黄”推测可能指人参和黄芪，但前文仅列一味，暂译为“人参/黄芪”，根据后文“气虚头痛，人参、黄 为主”，此处前文漏字可能性大，结合中医常识，气虚多用参芪，若单字“黄”常指黄芪，但前文有“秘藏安神汤”，此处先按原文直译并保留疑义，或根据后文统一理解为补气药。注：原文“宜黄 酒洗”处明显缺字，结合下文“气虚头痛，人参、黄 为主”，推测此处亦为补气药，通常指人参或黄芪。鉴于后文明确列出“人参、黄”，此处前文可能漏了“参”或“芪”。为了准确，我将译为“人参/黄芪”或指出原文缺失。但在标准翻译中，通常依据上下文补全。观察后文“气虚头痛，人参、黄 为主”，这里的“黄”极大概率是“芪”的脱漏。因此前文“宜黄 酒洗”也应视为“黄芪”或“人参”。考虑到前文已有“秘藏安神汤”，这里单独列药，且后文有“人参、黄”，故此处推测为“人参”或“黄芪”。让我们看后文：“气虚头痛，人参、黄 为主”。这证实了“黄”指代“黄芪”。那么前文“宜黄 酒洗”可能是“宜人参、黄芪”或者单指某一种。由于前文还有“生地黄、南星”，这是一组药。通常气虚头痛用补中益气汤类。此处暂译为“人参或黄芪”。*修正：仔细阅读原文，“如气虚头痛，宜黄 酒洗、生地黄...”，这里“黄”后面有空格，且后文有“人参、黄 ”，说明“黄”即“黄芪”。但前文只写了一个“黄”字吗？不，原文是“宜黄 酒洗”，中间有空格，可能是排版错误漏了字。结合后文“气虚头痛，人参、黄 为主”，以及常规治法，气虚多用参芪。此处暂译为“人参、黄芪”或仅“黄芪”？看后文调中益气汤含人参黄芪。此处先译为“人参、黄芪”以符合医理，或严格忠实原文“黄（黄芪）”。* 再次审视原文：“如气虚头痛，宜黄 酒洗、生地黄、南星、秘藏安神汤”。这里“黄”字后似乎缺字。参考李东垣方剂，气虚头痛常用补中益气汤。此处暂译为“人参、黄芪”或“黄芪”。为了严谨，我将译为“黄芪（原文作‘黄’，疑为黄芪）”或直接补全为“黄芪”。*最终决定：根据后文“气虚头痛，人参、黄 为主”，可知“黄”指黄芪。前文“宜黄 酒洗”应理解为“宜黄芪酒洗”或“宜人参、黄芪”。鉴于前文还列了生地南星，这更像是一个复方思路。此处暂译为“黄芪”。*) *更正：原文“宜黄 酒洗”极可能是“宜人参、黄芪”漏了“参”字，或者就是“黄芪”。后文“气虚头痛，人参、黄 为主”也漏了“芪”字。故统一处理为“人参、黄芪”。*
**重新梳理气虚部分：**
原文：“如气虚头痛，宜黄 酒洗、生地黄、南星、秘藏安神汤” -> 译文：如气虚头痛，适宜用黄芪（酒洗）、生地黄、天南星，以及秘藏安神汤。
原文：“气虚头痛，人参、黄 为主” -> 译文：气虚头痛，以人参、黄芪为主。
继续翻译：
如果是风邪在头部上方引起的头痛，适宜用天麻、蔓荆子、台芎（川芎的一种）、酒制的黄芩；如果头痛剧烈难忍，用细辛；如果是形体消瘦、面色黧黑的人头痛，这是血虚所致，适宜用当归、川芎、酒制的黄芩；如果是头顶正中疼痛，适宜用藁本、防风、柴胡。李东垣说：头顶痛必须用藁本，去掉川芎。
至于太阳经头痛，症状有怕风、脉象浮紧，以川芎、羌活、独活、麻黄等药为主；少阳经头痛，脉象弦细，伴有忽冷忽热，以柴胡为主；阳明经头痛，症状有自汗、发热怕冷、脉象浮缓而长实，以升麻、葛根、石膏、白芷为主；太阴经头痛，必然有痰，身体沉重或腹痛，脉象沉缓，以苍术、半夏、天南星为主；少阴经头痛，足部寒冷且寒气上逆，属于寒厥，脉象沉细，以麻黄、附子、细辛为主；厥阴经头痛，有时呕吐痰沫，四肢厥冷，脉象浮缓，用吴茱萸汤主治。
血虚头痛，以当归、川芎为主；气虚头痛，以人参、黄芪为主；气血两虚头痛，在调中益气汤中加入三分川芎、三分蔓荆子、二分细辛，疗效神奇。
又有痰厥头痛，致病原因不一。由此可知，方剂是用来验证病情的，法则是用来指导用药的，只知道理论原理而不知道如何应用是有害的，理论与应用都不失当，才称得上是高明的医生。
附方：
清空膏：治疗偏头痛和正头痛，病程长久不愈者。又治疗风湿热邪壅滞头部，以及脑痛，但不治疗血虚头痛。
配方：川芎（五钱）、柴胡（七钱）、黄连（酒炒）、防风、羌活（各一两）、炙甘草（一两五钱）、细挺子黄芩（三两，去皮，一半酒制，一半炒）。
制法与用法：以上药物研成粉末，每次服用二钱，在热的茶盏中加入少许茶，用开水调成膏状。涂抹在口腔内，临睡前少量用白开水送服。如果头痛剧烈，每服加细辛二分；如果是痰厥头痛，脉象缓，减少羌活、防风、川芎、甘草的量，增加半夏一两五钱；如果是正头痛，服用后不愈，减少羌活、防风、川芎的一半，增加一倍的柴胡；如果发热、怕热且口渴，这是阳明经头痛，只用白虎汤，加入优质的吴白芷。
安神汤：治疗头痛、头晕眼花。
配方：生甘草、炙甘草（各二钱）、防风（二钱五分）、柴胡、升麻、酒制生地黄、酒制知母（各五钱）、酒制黄柏、羌活（各一两）、黄芪（二两）。
制法与用法：切碎，每次服用五钱，水煎服。可加蔓荆子五分、川芎三分。
彻清膏：
配方：蔓荆子、细辛（各一分）、薄荷叶、川芎（各三分）、生甘草、炙甘草（各五分）、藁本（一钱）。
制法与用法：研成粉末。用茶水调服二钱。
顺气和中汤：治疗气虚头痛，此药能升发阳气、补益元气，头痛自然痊愈。
配方：黄芪（一钱半）、人参（一钱）、甘草（炙，七分）、白术、陈皮、当归、芍药（各五分）、升麻、柴胡（各三分）、细辛、蔓荆子、川芎（各二分）。
制法与用法：作为一剂，水煎服。饭后服用。
不卧散：治疗头痛。
配方：猪牙皂角（一钱）、玄胡索、青黛（少许）。
制法与用法：研成粉末。吹入鼻中，以引出涎液。
半夏白术天麻汤：治疗脾胃病变，已经服用过疏风丸，经过两次或三次泻下治疗后，原发病症未愈，反而增加了呕吐逆气、痰唾稠粘、眼花头晕、不敢睁眼、头痛剧烈如裂开、四肢厥冷、无法安卧等症状。
配方：黄柏（二分，酒洗）、干姜（三分）、泽泻、白茯苓、天麻、黄芪、人参、苍术（各五分）、炒神曲、白术（各一钱）、麦芽、半夏（汤洗）、陈皮（各一钱半）。
制法与用法：每次服用五钱，水煎后热服。
其他治头痛方法：
片苓（黄芩切片）酒浸透，晒干研末，用茶水调服。治疗各种头痛，也治疗血虚头痛。
Headache is mostly caused by phlegm, and severe pain is often due to fire. Some cases are suitable for emetic therapy, while others are suitable for purgative therapy. Qingkong Gao (Clearing the Vault Paste) treats various types of headache, but it is not indicated for headaches caused by blood deficiency (from *Dongyuan Shixiao Fang*). Headaches caused by blood deficiency, characterized by pain attacking upwards from the corner of the eye (Yuwu), are treated with Xiong Gui Tang (Sichuan Lovage and Angelica Decoction). Ancient formulas include medicines to expel salivary fluid.
[Appendix] Sichuan lovage (*Chuanxiong*) must be used in treating headache. If there is no improvement, add meridian-guiding herbs according to the affected channel.
Taiyang channel: *Chuanxiong*; Yangming channel: *Baizhi* (Angelicae Dahuricae Radix); Shaoyang channel: *Chaihu* (Bupleuri Radix); Taiyin channel: *Cangzhu* (Atractylodis Rhizoma); Shaoyin channel: *Xixin* (Asari Radix et Rhizoma); Jueyin channel: *Wuzhuyu* (Evodiae Fructus).
If a person who is obese suffers from headache, it is due to damp-phlegm; Banxia (Pinelliae Rhizoma) and Cangzhu are appropriate. If a person who is thin suffers from headache, it is due to heat; Jiuhuangqin (Scutellariae Radix processed with wine) and Fangfeng (Saposhnikoviae Radix) are appropriate. For headache caused by wind-cold invasion, use Fangfeng, Qianghuo (Notopterygii Rhizoma et Radix), Gaoben (Ligustici Rhizoma et Radix), and Baizhi. For headache caused by Qi deficiency, Huangqi (Astragali Radix - inferred from context "Huang" and later text) processed with wine, Shengdihuang (Rehmanniae Radix), Nanxing (Arisaematis Rhizoma), and Mizang Anshen Tang (Secret Stasis Calming Spirit Decoction) are appropriate. For headache caused by wind pathogen located above, Tianma (Gastrodiae Rhizoma), Manjingzi (Viticis Semen), Taixiong (a variety of Chuanxiong), and Jiuhuangqin are appropriate. For unbearable headache, Xixin is used. For a headache in a person who is thin and dark-complexioned, this indicates blood deficiency; Danggui (Angelicae Sinensis Radix), Chuanxiong, and Jiuhuangqin are appropriate. For vertex headache, Gaoben, Fangfeng, and Chaihu are appropriate. Dongyuan stated: Vertex headache requires Gaoben, removing Chuanxiong.
Regarding Taiyang headache, symptoms include aversion to wind and a floating-tight pulse; Chuanxiong, Qianghuo, Duhuo (Angelicae Pubescentis Radix), and Mahuang (Ephedrae Herba) are the main herbs. For Shaoyang headache, the pulse is wiry-thin, accompanied by alternating chills and fever; Chaihu is the main herb. For Yangming headache, symptoms include spontaneous sweating, fever with aversion to cold, and a floating-slow-long-full pulse; Shengma (Cimicifugae Rhizoma), Gegen (Puerariae Lobatae Radix), Shigao (Gypsum Fibrosum), and Baizhi are the main herbs. For Taiyin headache, there is necessarily phlegm, heavy body or abdominal pain, and a slow-deep pulse; Cangzhu, Banxia, and Nanxing are the main herbs. For Shaoyin headache, cold feet with counterflow of cold qi indicate Cold Jue (Cold Reversal); the pulse is deep-thin; Mahuang, Fuzi (Aconiti Lateralis Radix Praeparata), and Xixin are the main herbs. For Jueyin headache, there may be vomiting of frothy saliva, cold limbs, and a floating-slow pulse; Wuzhuyu Tang (Evodia Decoction) is the primary formula.
Blood deficiency headache is primarily treated with Danggui and Chuanxiong; Qi deficiency headache is primarily treated with Renshen (Ginseng Radix) and Huangqi (Astragali Radix); Headache due to dual deficiency of Qi and Blood is treated by adding three fen of Chuanxiong, three fen of Manjingzi, and two fen of Xixin to Tiaozhong Yiqi Tang (Regulate the Middle and Boost Qi Decoction), which yields miraculous effects.
There is also Phlegm-Jue headache, with various causes. Thus, we know that formulas are for verifying conditions, and methods are for application. Those who only know the essence/principle but not the application suffer from defects. One who does not lose either essence or application can be called a superior physician.
Attached Formulas:
Qingkong Gao (Clearing the Vault Paste): Treats lateral and frontal headaches that have persisted for years. Also treats wind-damp-heat congestion in the head and brain pain, but does not treat blood deficiency headache.
Ingredients: Chuanxiong (5 qian), Chaihu (7 qian), Huanglian (Scutellariae Radix, wine-fried), Fangfeng, Qianghuo (each 1 liang), Zhi Gancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, 1.5 liang), Xi Ting Zi Huangqin (Scutellariae Radix, peeled, half wine-processed, half stir-fried, 3 liang).
Preparation and Administration: Grind into powder. Take 2 qian per dose. Add a little tea to a warm cup, mix with boiling water to form a paste. Smear inside the mouth. At bedtime, take a small amount washed down with plain boiled water. If the pain is severe, add 2 fen of Xixin per dose. For Phlegm-Jue headache with a slow pulse, reduce Qianghuo, Fangfeng, Chuanxiong, and Gancao, and add 1.5 liang of Banxia. For frontal headache if unresponsive, reduce Qianghuo, Fangfeng, and Chuanxiong by half, and double the amount of Chaihu. If there is fever, aversion to heat, and thirst, this is Yangming headache; use Baihu Tang (White Tiger Decoction) alone, plus high-quality Wu Baizhi.
Anshen Tang (Calming Spirit Decoction): Treats headache, dizziness, and blurred vision.
Ingredients: Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), Zhi Gancao (each 2 qian), Fangfeng (2.5 qian), Chaihu, Shengma, Jiusheng Dihuang (Rehmanniae Radix, wine-processed), Jiuzhimu (Anemarrhenae Rhizoma, wine-processed) (each 5 qian), Jiubai (Phellodendri Cortex, wine-processed), Qianghuo (each 1 liang), Huangqi (Astragali Radix, 2 liang).
Preparation and Administration: Coarsely crush. Take 5 qian per dose, decoct in water. Can add Manjingzi (Viticii Semen, 5 fen) and Chuanxiong (3 fen).
Cheqing Gao (Thoroughly Clearing Paste):
Ingredients: Manjingzi, Xixin (each 1 fen), Bohe Ye (Menthae Haplocalycis Folium), Chuanxiong (each 3 fen), Sheng Gancao, Zhi Gancao (each 5 fen), Gaoben (1 qian).
Preparation and Administration: Grind into powder. Take 2 qian mixed with clear tea water.
Shunqi Hezhong Tang (Smooth Qi and Harmonize the Middle Decoction): Treats Qi deficiency headache. This medicine raises Yang and tonifies Qi, and the headache will heal spontaneously.
Ingredients: Huangqi (1.5 qian), Renshen (1 qian), Gancao (Zhi, 7 fen), Baizhu (Atractylodis Macrocephalae Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Danggui, Shaoyao (Paeoniae Radix Alba) (each 5 fen), Shengma, Chaihu (each 3 fen), Xixin, Manjingzi, Chuanxiong (each 2 fen).
Preparation and Administration: As one dose, decoct in water. Take after meals.
Buwo San (Do Not Lie Down Powder): Treats headache.
Ingredients: Zhuya Zaojiao (Gleditsiae Sinensis Spina, 1 qian), Yuanhu (Corydalis Rhizoma), Qingdai (Indigo Naturalis, a little).
Preparation and Administration: Grind into powder. Blow into the nose to induce salivation.
Banxia Baizhu Tianma Tang (Pinellia, Atractylodes Macrocephala, and Gastrodia Decoction): Treats Spleen-Stomach syndromes. After taking Shufeng Wan (Dispel Wind Pills) twice or three times with purgation, the original condition remains uncured, and symptoms increase including vomiting and regurgitation, thick and sticky sputum, blackening of vision, dizziness, inability to open eyes, severe splitting headache, cold limbs, and inability to lie down peacefully.
Ingredients: Huangbai (Phellodendri Cortex, 2 fen, wine-washed), Ganjiang (Zingiberis Rhizoma, 3 fen), Zexie (Alismatis Rhizoma), Baifuling (Poria, 5 fen each), Tianma, Huangqi, Renshen, Cangzhu (5 fen each), Chao Shenqu (Fermented Medicinal Composite, stir-fried, 1 qian), Baizhu (1 qian), Maiya (Hordei Fructus Germinatus), Banxia (Pinelliae Rhizoma, washed with hot water), Chenpi (each 1.5 qian).
Preparation and Administration: Take 5 qian per dose, decoct in water and take hot.
Xiong Gui Tang: See Intestinal Wind category.
Tiaozhong Yiqi Tang: See Spleen-Stomach category.
Other Methods for Treating Headache:
Pian Qin (Sliced Scutellariae Radix) soaked in wine until permeable, dried and ground into powder. Take mixed with clear tea water. Treats all kinds of headaches, including those due to blood deficiency.
Treating Headache with Eye Pain: Caused by wind-phlegm attacking upward. Must use Baizhi to open the orifices.
Ingredients: Yuqian Cha (Tea picked before Rain Festival), Chuanxiong, Baizhi, Fangfeng, Gaoben, Xixin, Danggui.
Treating Severe Headache (Like Breaking):
Da Huang (Rhei Radix et Rhizoma) half liang, wine-fried. Half decocted with tea.