伤寒头痛，常痛不休，不比内伤头痛，时作时止。故伤寒头痛发热，三阳经者多。然三阳
中，惟太阳经更多。故头痛身痛，恶寒发热，两足常冷，皆太阳表症也。无汗脉浮紧，北方
冬月麻黄汤，南方羌活败毒散；有汗脉浮缓，北方冬月桂枝汤，南方加减防风汤合川芎汤。
少阳经头角痛，痛引耳前后，发热无汗，脉浮紧，柴胡防风汤；脉弦而数，寒热往来，合目
自汗，呕而口苦，小柴胡汤。通加川芎入胆，上行头角。阳明经额前痛，痛连眼眶，脉洪而
长，发热无汗者，葛根汤加葱白、白芷、升麻；有汗发热，脉洪而数，烦渴引水，白虎汤加
葛根、白芷。若手足 多汗，大便不行，脐腹胀满，虽有头痛之表症，亦用大干葛汤下
之。又有头痛鼻塞，咳嗽喘急，每夜寒热，此风寒入肺，即伤风头痛也，宜芎苏泻白散；若
无汗恶寒，脉浮紧，加羌活。又有风温头痛，宜防风散加石膏、干葛。湿温头痛，宜防风神
术汤。又有时常头风痛者，羌活、选奇汤。顽痰头痛，胸满恶心者，二陈汤加南星、海石
饮家头痛，胸胁胀满，恶心呕吐，平胃二陈汤、导痰汤，甚者控涎丹，不愈再加瓜蒂散，搐
鼻出黄水。又火痰头痛，栀连二陈汤加胆星。又有阴火头痛，四物汤加黄柏、知母。另有阴
症头痛，此直中阴经之寒症，北方人有之，江浙则少。又有冒寒头痛，遇冷头痛，似阴症头
痛，实非阴症寒痛，皆是内有痰饮积热，外遇寒冷搏击而痛也。
太阳之病，脉浮头项强痛而恶寒。
此合论太阳经表症，必脉浮头项强痛而恶寒，宜发汗者。
太阳病，头痛发热，汗出恶风者，桂枝汤主之。太阳病头痛发热，身疼腰痛，骨节疼痛，无
汗而喘者，麻黄汤主之。
此分论太阳病中风、伤寒二症，各立方以主治也。
太阳病头痛，至七日以上自愈者，以行其经尽故也。若欲再传经者，针足阳明，使经不传。
针阳明，刺腕骨、余骨、合谷三穴也。言太阳病头痛发热之症，若七日以上行其经尽，自
愈者则已。若不愈，针此三穴，使不传经。
伤寒不大便六七日，头痛有热者，与小承气汤。其小便清者，知不在里，仍在表也，须当发
汗。若头痛者，必衄，宜桂枝汤。
不大便六七日，有里热，即头痛，亦宜小承气汤下之。但验其小便，若不赤，邪热未入
里，须当发汗，故宜用桂枝汤。若服后头仍痛者，此热邪得桂枝之热，侵入阳明，必迫血
从鼻而衄矣。宜桂枝汤句，应在须当发汗句之下。
太阳中风，下利呕逆，表散者，乃可攻之。其人 汗出，发作有时，头痛，心下硬满，引
胁下痛，干呕短气，汗出不恶寒者，此表解里未和也，十枣汤主之。此条详注呕吐门。
阳明病，表里大热，烦渴引饮，头痛如破者，宜竹叶石膏汤。
阳明表里之症，当用干葛石膏汤。今因烦渴引饮，头痛如破，此火热上冲猛烈，故用竹叶石膏汤。
阳明头痛，不恶寒反恶热，大便实，宜调胃承气汤。
不恶寒反恶热，大便实，阳明里热症也。不用大承气者，微示头痛症不可大下也。
伤寒脉弦细，头痛发热者，属少阳，不可发汗，汗之则谵语。此属胃，胃和则愈，不和则烦而悸。
头痛发热，是太阳症，今脉弦而细，属少阳之脉，故不可用麻黄汤误汗。
厥阴头痛，干呕吐涎沫，吴茱萸汤主之。
此厥阴经阴症头痛也。
麻黄汤 见恶寒。
羌活冲和汤 见发热。
桂枝汤 见恶寒。
加减防风汤 见身痛。
川芎汤
川芎 苍术 羌活 防风 荆芥 甘草
此治太阳经风湿头痛方也。兼寒者，加细辛；阳明见症，加白芷；少阳见症，加柴胡；有
火者，加黄芩，即合选奇汤。
柴胡防风汤 即小柴胡汤加防风。
此治少阳风邪头痛之方。
小柴胡汤 加减详寒热门。
二白干葛汤
葱白 白芷 干葛 升麻
此阳明表邪头痛之方。症兼太阳者，加羌活、防风、川芎。症兼少阳者，加柴胡、川芎；
胸前呕恶，合二陈平胃散；有火者，加栀连。
白虎葛根汤
知母 石膏 葛根 白芷
此阳明里热头痛之方。若带太阳表邪，加羌活、防风，症兼少阳，加柴胡、川芎，小便黄
赤，加木通、滑石；大便不通，有下症者，加酒煮大黄。
大葛根汤
干葛 石膏 枳壳 大黄 广皮 甘草 知母
此治阳明表邪未尽，大便秘结，积热上冲头痛之方。若带恶寒表热，症兼太阳者，即不可用。
芎苏泻白散
川芎 紫苏 防风 桑白皮 地骨皮 荆芥 甘草
此治风伤肺气，咳嗽寒热头痛之方。若症兼太阳，加羌活，兼阳明，加干葛、白芷，兼少
阳，加柴胡。
防风散
防风 桔梗 浓朴 甘草 石膏 干葛
此治肺胃二经，风热上冲头痛之方。防风散风，石膏清热，与桔梗同用，清肺也；与干葛
同用，清胃也。浓朴、甘草和胃气以升降浮沉也。兼少阳者，加柴胡、川芎、薄荷、荆芥。
防风神术汤
防风 苍术 甘草 石膏
此治风湿热三气头痛之方。风气胜者，倍防风加羌活，湿气胜者，倍苍术加白芷，热气胜
者，倍石膏加黄柏；太阳见症，加 本；阳明见症，加升麻；少阳见症，加柴胡。通加川
芎少许，上行头角。
羌活选奇汤
羌活 防风 黄芩 甘草
此治太阳风热头痛之方。若少阳见症，加柴胡、川芎；阳明见症，加升麻、白芷。风热
甚，加薄荷、荆芥、 本；里有积热，加栀、连；若时常痛发，俗名头风痛者，加蔓荆
子、 本；冒寒即痛，加细辛、川芎。
星石二陈汤 即二陈汤加胆星石菖蒲。
此治痰饮凝结中脘，上冲头额，时常作痛之方。兼风者，加防风、荆芥；兼火者，加栀、
连；兼寒者、加细辛、川芎；发热恶寒，加羌活；头额作痛，痛连于目，加干葛、白芷、升
麻；往来寒热，痛连头角，下连耳之前后，加柴胡、川芎。
平胃二陈汤 即二陈汤和平胃散。
时常头痛，俗名头风痛。本于内伏痰积，外冒风寒，是以头痛之症。若兼恶心饱闷者，必
痰积作患。余尝以此方合保和散，重加豆蔻、石菖蒲、莱菔子，除去在胃之病根，则痛不发。
导痰汤 见似疟。
头痛症，兼呕吐恶心者，则以此方治痰饮。若外冒寒者，加羌活、细辛、蔓荆子、川芎、
本；冒风者，加防风、荆芥；冒暑热者，加黄连、滑石；冒风湿者，加防风、苍术、白芷、石菖蒲。
控涎丹
甘遂 大戟 白芥子
痰饮伏于胁下作痛，名悬饮支饮，用十枣汤。痰伏胃家，上攻头额作痛，则用控涎丹。同
用甘遂、大戟，彼以芫花易白芥子，此以白芥子易芫花。同一痰饮病，一痛于胁，一痛于
头，故有上散下行之不同。
二陈栀连胆星汤 即二陈汤加栀、连、胆星。
上条皆是痰饮，此乃痰火上冲。若外有感冒，加散表之药，先去外邪。
四物知柏汤 即四物汤加知母、黄柏。
此方本治内伤阴火，内冲头痛。立此互考，相得益彰。
十枣汤 见胁痛。
竹叶石膏汤 见口渴。
调胃承气汤 见大便结。
外感头痛，禁用下行。今以阳明头痛，不恶寒反恶热，大便实，故以此方微下之。
伤寒引起的头痛，通常持续疼痛不止，不同于内伤引起的头痛，时痛时止。因此，伤寒伴有发热的头痛，多属于三阳经的病证。然而在三阳经中，以太阳经受邪最为多见。所以，头痛、身体疼痛、恶寒发热、双脚常感寒冷，都是太阳经的表证。若表现为无汗、脉象浮紧，北方冬季可用麻黄汤，南方则用羌活败毒散；若表现为有汗、脉象浮缓，北方冬季可用桂枝汤，南方则用加减防风汤合川芎汤。
少阳经头痛表现为头角部疼痛，疼痛牵引耳前耳后，发热无汗，脉象浮紧，宜用柴胡防风汤；若脉象弦而数，寒热往来，闭目自汗，呕吐且口苦，宜用小柴胡汤。通常加入川芎以入胆经，上行至头角。
阳明经头痛表现为额前疼痛，疼痛牵连眼眶，脉象洪大而长，发热无汗者，宜用葛根汤加葱白、白芷、升麻；若有汗发热，脉象洪大而数，心烦口渴想喝水，宜用白虎汤加葛根、白芷。如果手足多汗，大便不通，脐腹部胀满，虽然也有头痛的表证，也应用大干葛汤攻下。
又有头痛鼻塞，咳嗽气喘急促，每晚出现寒热交替，这是风寒侵入肺脏，即所谓的伤风头痛，宜用芎苏泻白散；若无汗恶寒，脉象浮紧，可加羌活。又有风温引起的头痛，宜用防风散加石膏、干葛。湿温引起的头痛，宜用防风神术汤。还有时常发作的头风痛，可用羌活选奇汤。顽痰引起的头痛，伴有胸满恶心者，用二陈汤加南星、海浮石。饮酒者引起的头痛，伴有胸胁胀满，恶心呕吐，用平胃二陈汤或导痰汤，严重的用控涎丹，若不愈再加瓜蒂散，通过搐鼻排出黄水。又有火痰引起的头痛，用栀连二陈汤加胆南星。又有阴火引起的头痛，用四物汤加黄柏、知母。另有阴症头痛，这是寒邪直中阴经的寒证，北方人有此病，江浙地区较少见。又有冒寒头痛，遇冷则头痛，看似阴症头痛，实则并非阴症寒痛，都是因为内有痰饮积热，外遇寒冷搏击而致痛。
太阳病的脉象是浮脉，症状是头项强痛且恶寒。
这是对太阳经表证的总论，必定出现脉浮、头项强痛、恶寒的症状，适宜采用发汗法治疗。
太阳病，出现头痛、发热、出汗、恶风，由桂枝汤主治。太阳病出现头痛、发热、身体疼痛、腰痛、骨节疼痛、无汗且喘息，由麻黄汤主治。
这是分别论述太阳病中的中风和伤寒两种证候，各自设立方剂以主治。
太阳病头痛，经过七天以上自行痊愈的，是因为邪气在经脉中运行完毕的缘故。如果想要防止邪气传入其他经脉，可以针刺足阳明经穴位，使邪气不传变。
针刺阳明经，是指刺腕骨、余骨（指阳谷穴附近）、合谷这三个穴位。意思是说太阳病头痛发热的症状，如果七天以上邪气行尽，自愈的就罢了；如果不愈，针刺这三个穴位，使邪气不传变。
伤寒后六七天不大便，头痛且有发热，给予小承气汤。如果小便清长，说明病不在里，仍在表，应当发汗。如果头痛，可能会发生鼻衄，宜用桂枝汤。
不大便六七天，有里热，即使头痛，也宜用小承气汤攻下。但需查验其小便，如果不赤红，说明邪热未入里，应当发汗，故宜用桂枝汤。如果服药后头痛仍不缓解，这是因为热邪借助桂枝汤的热性，侵入阳明经，必然逼迫血液从鼻腔而出导致鼻衄。原文中“宜桂枝汤”一句，应放在“须当发汗”一句之下。
太阳中风，伴有下利、呕逆，应先解表，然后才可攻里。其人出汗，发作有时，头痛，心下部硬满，牵引胁下疼痛，干呕短气，出汗且不恶寒，这是表证已解而里气未和，由十枣汤主治。此条详细注释在呕吐门中。
阳明病，表里俱热，心烦口渴想饮水，头痛剧烈如破裂感，宜用竹叶石膏汤。
阳明病的表里症状，本应用干葛石膏汤。如今因烦渴引饮，头痛如破，这是火热上冲猛烈，故用竹叶石膏汤。
阳明头痛，不恶寒反而恶热，大便干结，宜用调胃承气汤。
不恶寒反恶热，大便干结，是阳明里热证。不用大承气汤，是微微示意头痛证不可峻下。
伤寒脉象弦细，头痛发热，属于少阳病，不可发汗，发汗则会出现谵语。这属于胃的问题，胃气和顺则痊愈，不和顺则烦躁心悸。
头痛发热本是太阳病症状，如今脉象弦而细，属于少阳脉，故不可误用麻黄汤发汗。
厥阴头痛，干呕并吐出涎沫，由吴茱萸汤主治。
这是厥阴经的阴症头痛。
麻黄汤 参见恶寒条。
羌活冲和汤 参见发热条。
桂枝汤 参见恶寒条。
加减防风汤 参见身痛条。
川芎汤
组成：川芎、苍术、羌活、防风、荆芥、甘草。
这是治疗太阳经风湿头痛的方剂。兼有寒邪的，加细辛；出现阳明见证的，加白芷；出现少阳见证的，加柴胡；有火的，加黄芩，即合用选奇汤。
柴胡防风汤 即小柴胡汤加防风。
这是治疗少阳风邪头痛的方剂。
小柴胡汤 加减详见寒热门。
二白干葛汤
组成：葱白、白芷、干葛、升麻。
这是治疗阳明表邪头痛的方剂。症状兼有太阳的，加羌活、防风、川芎；症状兼有少阳的，加柴胡、川芎；胸前呕恶，合用二陈平胃散；有火的，加栀子、黄连。
白虎葛根汤
组成：知母、石膏、葛根、白芷。
这是治疗阳明里热头痛的方剂。若带有太阳表邪，加羌活、防风；症状兼有少阳，加柴胡、川芎；小便黄赤，加木通、滑石；大便不通，有可下之症的，加酒煮大黄。
大葛根汤
组成：干葛、石膏、枳壳、大黄、广皮、甘草、知母。
这是治疗阳明表邪未尽，大便秘结，积热上冲引起头痛的方剂。若带有恶寒表热，症状兼有太阳的，则不可用。
芎苏泻白散
组成：川芎、紫苏、防风、桑白皮、地骨皮、荆芥、甘草。
这是治疗风邪伤肺气，咳嗽寒热头痛的方剂。若症状兼有太阳，加羌活；兼阳明，加干葛、白芷；兼少阳，加柴胡。
防风散
组成：防风、桔梗、浓朴、甘草、石膏、干葛。
这是治疗肺胃二经风热上冲引起头痛的方剂。防风疏散风邪，石膏清热，与桔梗同用，清肺热；与干葛同用，清胃热。浓朴、甘草调和胃气以升降浮沉。兼有少阳的，加柴胡、川芎、薄荷、荆芥。
防风神术汤
组成：防风、苍术、甘草、石膏。
这是治疗风湿热三气引起头痛的方剂。风气盛的，加倍防风加羌活；湿气盛的，加倍苍术加白芷；热气盛的，加倍石膏加黄柏；出现太阳见证，加藁本；出现阳明见证，加升麻；出现少阳见证，加柴胡。通常加少许川芎，上行至头角。
羌活选奇汤
组成：羌活、防风、黄芩、甘草。
这是治疗太阳风热头痛的方剂。若出现少阳见证，加柴胡、川芎；出现阳明见证，加升麻、白芷。风热甚重的，加薄荷、荆芥、藁本；里有积热的，加栀子、黄连；若时常痛发，俗名头风痛的，加蔓荆子、藁本；冒寒即痛的，加细辛、川芎。
星石二陈汤 即二陈汤加胆南星、石菖蒲。
这是治疗痰饮凝结中脘，上冲头额，时常作痛的方剂。兼风的，加防风、荆芥；兼火的，加栀子、黄连；兼寒的，加细辛、川芎；发热恶寒，加羌活；头额作痛，痛连于目，加干葛、白芷、升麻；往来寒热，痛连头角，下连耳之前后，加柴胡、川芎。
平胃二陈汤 即二陈汤和平胃散合方。
时常头痛，俗名头风痛。病本在于内伏痰积，外冒风寒，因而导致头痛。若兼有恶心饱闷，必然是痰积为患。我曾用此方合保和散，重加豆蔻、石菖蒲、莱菔子，去除胃中的病根，则疼痛不再发作。
导痰汤 参见似疟条。
头痛症状兼有呕吐恶心的，则以此方治疗痰饮。若外冒寒邪，加羌活、细辛、蔓荆子、川芎、藁本；冒风邪，加防风、荆芥；冒暑热，加黄连、滑石；冒风湿，加防风、苍术、白芷、石菖蒲。
控涎丹
组成：甘遂、大戟、白芥子。
痰饮伏于胁下作痛，名为悬饮、支饮，用十枣汤。痰伏于胃家，上攻头额作痛，则用控涎丹。两方同用甘遂、大戟，十枣汤以芫花易白芥子，控涎丹以白芥子易芫花。同为痰饮病，一痛于胁，一痛于头，故有上散下行之不同。
二陈栀连胆星汤 即二陈汤加栀子、黄连、胆南星。
上一条所述皆是痰饮，此条乃是痰火上冲。若外有感冒，加发散表邪的药物，先去外邪。
四物知柏汤 即四物汤加知母、黄柏。
此方本治内伤阴火，内冲引起头痛。立此方以供互考，相得益彰。
十枣汤 参见胁痛条。
竹叶石膏汤 参见口渴条。
调胃承气汤 参见大便结条。
外感头痛，禁用下行攻伐之法。如今因为阳明头痛，不恶寒反恶热，大便干实，故以此方轻微攻下。
Headache caused by Shanghan (Cold Damage) typically involves continuous pain without cessation, unlike headache due to internal injury, which comes and goes intermittently. Therefore, headache accompanied by fever in Shanghan is mostly related to the Three Yang meridians. Among the Three Yang meridians, the Taiyang (Greater Yang) meridian is most frequently involved. Thus, headache, body ache, aversion to cold, fever, and constant coldness of both feet are all exterior syndromes of the Taiyang meridian. If there is no sweating and the pulse is floating and tight, Mahuang Tang (Ephedra Decoction) may be used in the north during winter, or Qianghuo Baidu San (Notopterygium Decoction for Overcoming Toxins) in the south; if there is sweating and the pulse is floating and slow, Guizhi Tang (Cinnamon Twig Decoction) may be used in the north during winter, or Jiajian Fangfeng Tang (Modified Saposhnikovia Decoction) combined with Chuanxiong Tang (Ligusticum Decoction) in the south.
Headache of the Shaoyang (Lesser Yang) meridian manifests as pain at the temples, radiating to the areas before and behind the ears, accompanied by fever, absence of sweating, and a floating-tight pulse; Chaihu Fangfeng Tang (Bupleurum and Saposhnikovia Decoction) is indicated. If the pulse is wiry and rapid, with alternating chills and fever, spontaneous sweating when closing the eyes, vomiting, and bitter taste in the mouth, Xiaochaihu Tang (Minor Bupleurum Decoction) is indicated. Usually, Chuanxiong Rhizoma (Chuanxiong) is added to enter the Gallbladder meridian and ascend to the temples.
Headache of the Yangming (Yang Brightness) meridian presents as pain in the forehead, radiating to the eye sockets, with a surging and long pulse. For those with fever and no sweating, Gegen Tang (Kudzu Root Decoction) plus Congbai (Scallion White), Baizhi (Angelica Dahurica), and Shengma (Cimicifuga) is used. For those with fever and sweating, with a surging and rapid pulse, irritability, thirst, and desire to drink water, Baihu Tang (White Tiger Decoction) plus Gegen (Kudzu Root) and Baizhi (Angelica Dahurica) is used. If there is excessive sweating on the hands and feet, constipation, and abdominal distension and fullness around the umbilicus, even though there are exterior symptoms of headache, Da Gange Tang (Large Kudzu Root Decoction) should be used to purge.
There is also headache with nasal congestion, coughing, and急促 wheezing, with nightly alternating chills and fever; this is wind-cold invading the Lung, known as Shangfeng (Wind Injury) headache, treated with Xiong Su Xiebai San (Ligusticum and Perilla Decoction for Draining the Lungs). If there is no sweating and aversion to cold with a floating-tight pulse, add Qianghuo (Notopterygium). Headache due to Wind-Warmth is treated with Fangfeng San (Saposhnikovia Powder) plus Shigao (Gypsum) and Gange (Kudzu Root). Headache due to Damp-Warmth is treated with Fangfeng Shenzhu Tang (Saposhnikovia and Atractylodes Decoction). Frequent "Toufeng" (Head Wind) headaches are treated with Qianghuo Xuanqi Tang (Notopterygium Marvellous Selection Decoction). Headache due to stubborn phlegm, accompanied by chest fullness and nausea, is treated with Erchen Tang (Two-Aged Decoction) plus Nanting (Arisaema Cum Melle) and Haishi (Floating Stone). Headache due to drinking alcohol, accompanied by chest and hypochondriac distension, nausea, and vomiting, is treated with Pingwei Erchen Tang (Stomach-Pacifying Two-Aged Decoction) or Daotan Tang (Phlegm-Resolving Decoction); severe cases use Kongxian Dan (Phlegm-Fluid Expelling Pill), and if ineffective, Guiti San (Melon Peduncle Powder) is used to snuff out yellow fluid. Headache due to Fire-Phlegm is treated with Zhilian Erchen Tang (Gardenia and Coptis Two-Aged Decoction) plus Danning (Gall-Bile Arisaema). Headache due to Yin-Fire is treated with Siwu Tang (Four Substances Decoction) plus Huangbai (Phellodendron) and Zimu (Anemarrhena). There is also Yin-syndrome headache, which is a cold syndrome directly entering the Yin meridians; this is seen more in the north and less in Jiangsu and Zhejiang. There is also Maohan (Exposure to Cold) headache, where headache occurs upon exposure to cold; it resembles Yin-syndrome headache but is not actually Yin-cold headache. It is caused by internal accumulation of phlegm-fluids and heat, combated by external cold.
The disease of Taiyang is characterized by a floating pulse, stiffness and pain in the head and nape, and aversion to cold.
This is a general discussion of Taiyang exterior syndromes: one must have a floating pulse, stiffness and pain in the head and nape, and aversion to cold, indicating that diaphoresis (sweating method) is appropriate.
For Taiyang disease presenting with headache, fever, sweating, and aversion to wind, Guizhi Tang (Cinnamon Twig Decoction) is the primary treatment. For Taiyang disease presenting with headache, fever, body ache, lower back pain, joint pain, absence of sweating, and wheezing, Mahuang Tang (Ephedra Decoction) is the primary treatment.
This separately discusses the two syndromes of Zhongfeng (Wind Strike) and Shanghan (Cold Damage) in Taiyang disease, prescribing respective formulas for each.
If Taiyang disease headache persists for seven days or more and heals spontaneously, it is because the pathogen has exhausted its course through the meridian. If transmission to other meridians is desired to be prevented, acupuncture points of the Foot-Yangming meridian can be stimulated to prevent transmission.
Acupuncture of the Yangming meridian refers to stimulating the three points: Wanguguxue (Wangu), Yuguxue (Yugu), and Hegu (LI4). This means that for Taiyang disease headache and fever, if the condition resolves spontaneously after seven days as the pathogen completes its course, it is fine. If not resolved, stimulating these three points prevents transmission.
In Shanghan, if there is no bowel movement for six or seven days, accompanied by headache and fever, Xiao Chengqi Tang (Minor Order the Qi Decoction) is given. If the urine is clear, it indicates the pathogen is not in the interior but remains in the exterior, requiring diaphoresis. If there is headache, epistaxis (nosebleed) will likely occur, and Guizhi Tang (Cinnamon Twig Decoction) is suitable.
With no bowel movement for six or seven days and interior heat, even with headache, Xiao Chengqi Tang (Minor Order the Qi Decoction) should be used to purge. However, check the urine; if not red, the pathogenic heat has not entered the interior, so diaphoresis is required, hence Guizhi Tang (Cinnamon Twig Decoction) is appropriate. If headache persists after taking the medicine, it is because the heat pathogen, aided by the warmth of Guizhi Tang, invades the Yangming meridian, forcing blood to escape from the nose causing epistaxis. The phrase "Guizhi Tang is suitable" should logically follow "diaphoresis is required."
In Taiyang Zhongfeng (Wind Strike), if accompanied by diarrhea and vomiting/retching, the exterior should be released first before attacking the interior. If the patient sweats, attacks occur at specific times, with headache, hardness and fullness below the heart radiating to the hypochondrium, dry retching, shortness of breath, sweating without aversion to cold, this indicates the exterior is resolved but the interior is not harmonized; Shizao Tang (Ten Jujubes Decoction) is the primary treatment. This clause is detailed in the Vomiting section.
In Yangming disease, with intense heat in both exterior and interior, irritability, thirst with desire to drink, and headache feeling like bursting, Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) is indicated.
For Yangming exterior and interior symptoms, Gan Ge Shi Gao Tang (Kudzu and Gypsum Decoction) would normally be used. Now, due to irritability, thirst, and bursting headache, indicating fierce upward rushing of fire-heat, Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) is used.
Yangming headache, characterized by aversion to heat rather than cold, and solid stool, is treated with Tiaowei Chengqi Tang (Regulate the Stomach Order the Qi Decoction).
Aversion to heat rather than cold and solid stool indicate Yangming interior heat. Da Chengqi Tang (Major Order the Qi Decoction) is not used to subtly indicate that headache syndromes should not be heavily purged.
In Shanghan, if the pulse is wiry and thin, with headache and fever, it belongs to Shaoyang. Diaphoresis is contraindicated; inducing sweating leads to delirious speech. This relates to the Stomach; if the Stomach qi harmonizes, recovery occurs; if not, irritability and palpitations result.
Headache and fever are Taiyang symptoms, but a wiry and thin pulse indicates Shaoyang. Therefore, Mahuang Tang (Ephedra Decoction) should not be mistakenly used for diaphoresis.
Jueyin headache, with dry retching and spitting of saliva, is treated with Wuzhuyu Tang (Evodia Decoction).
This is a Yin-syndrome headache of the Jueyin meridian.
Mahuang Tang (Ephedra Decoction) - See Averson to Cold.
Qianghuo Chonghe Tang (Notopterygium Harmony Decoction) - See Fever.
Guizhi Tang (Cinnamon Twig Decoction) - See Averson to Cold.
Jiajian Fangfeng Tang (Modified Saposhnikovia Decoction) - See Body Pain.
Chuanxiong Tang (Ligusticum Decoction)
Ingredients: Chuanxiong Rhizoma (Chuanxiong), Atractylodis Rhizoma (Cangzhu), Notopterygii Rhizoma et Radix (Qianghuo), Saposhnikoviae Radix (Fangfeng), Schizonepetae Herba (Jingjie), Glycyrrhizae Radix et Rhizoma (Gancao).
This formula treats Taiyang meridian headache due to Wind-Damp. For accompanying cold, add Asari Radix (Xixin); for Yangming signs, add Angelicae Dahuricae Radix (Baizhi); for Shaoyang signs, add Bupleuri Radix (Chaihu); for fire, add Scutellariae Radix (Huangqin), combining with Xuanqi Tang.
Chaihu Fangfeng Tang (Bupleurum and Saposhnikovia Decoction) is Xiaochaihu Tang (Minor Bupleurum Decoction) plus Fangfeng (Saposhnikovia).
This formula treats Shaoyang wind-pathogen headache.
Xiaochaihu Tang (Minor Bupleurum Decoction) - See variations in Cold-Heat section.
Er Bai Gan Ge Tang (Two Whites and Kudzu Decoction)
Ingredients: Congbai (Scallion White), Baizhi (Angelica Dahurica), Gange (Kudzu Root), Shengma (Cimicifuga).
This formula treats Yangming exterior pathogen headache. For signs involving Taiyang, add Qianghuo (Notopterygium), Fangfeng (Saposhnikovia), Chuanxiong (Ligusticum); for signs involving Shaoyang, add Chaihu (Bupleurum), Chuanxiong (Ligusticum); for chest nausea/vomiting, combine with Erchen Pingwei San (Two-Aged Stomach-Pacifying Powder); for fire, add Zhizi (Gardenia), Lianzi (Coptis).
Baihu Gegen Tang (White Tiger and Kudzu Decoction)
Ingredients: Zimu (Anemarrhena), Shigao (Gypsum), Gegen (Kudzu Root), Baizhi (Angelica Dahurica).
This formula treats Yangming interior heat headache. If accompanied by Taiyang exterior pathogen, add Qianghuo (Notopterygium), Fangfeng (Saposhnikovia); for Shaoyang signs, add Chaihu (Bupleurum), Chuanxiong (Ligusticum); for yellow-red urine, add Mutong (Akebia), Huashi (Talc); for constipation with purge indications, add Jiuzhu Dahuang (Wine-processed Rheum).
Da Gange Tang (Large Kudzu Root Decoction)
Ingredients: Gange (Kudzu Root), Shigao (Gypsum), Zhike (Aurantii Fructus), Dahuang (Rheum), Guangpi (Tangerine Peel), Gancao (Licorice), Zimu (Anemarrhena).
This formula treats headache due to residual Yangming exterior pathogen, constipation, and upward rushing of accumulated heat. If accompanied by aversion to cold and exterior heat, or signs involving Taiyang, it should not be used.
Xiong Su Xiebai San (Ligusticum and Perilla Decoction for Draining the Lungs)
Ingredients: Chuanxiong Rhizoma (Chuanxiong), Perillae Folium (Zisu), Saposhnikoviae Radix (Fangfeng), Morus Albae Cortex (Sangbaipi), Psoraleae Fructus (Digupi - *Note: Text says Digupi, usually Cornus or others, but here likely refers to a specific bark/root context or typo for Digupi/Psoralea or similar, keeping literal*), Schizonepetae Herba (Jingjie), Glycyrrhizae Radix et Rhizoma (Gancao).
This formula treats headache with cough and chills/fever due to wind injuring Lung qi. For Taiyang signs, add Qianghuo (Notopterygium); for Yangming signs, add Gange (Kudzu), Baizhi (Angelica Dahurica); for Shaoyang signs, add Chaihu (Bupleurum).
Fangfeng San (Saposhnikovia Powder)
Ingredients: Fangfeng (Saposhnikovia), Platycodonis Radix (Jiegeng), Magnoliae Officinalis Cortex (Nongpo/Magnolia Bark), Glycyrrhizae Radix et Rhizoma (Gancao), Shigao (Gypsum), Gange (Kudzu Root).
This formula treats headache due to Wind-Heat rushing up from the Lung and Stomach meridians. Fangfeng disperses wind, Shigao clears heat; combined with Jiegeng (Platycodon), it clears Lung heat; combined with Gange (Kudzu), it clears Stomach heat. Nongpo (Magnolia Bark) and Gancao (Licorice) harmonize Stomach qi to regulate ascending/descending and floating/sinking. For Shaoyang signs, add Chaihu (Bupleurum), Chuanxiong (Ligusticum), Bohe (Mint), Jingjie (Schizonepeta).
Fangfeng Shenzhu Tang (Saposhnikovia and Atractylodes Decoction)
Ingredients: Fangfeng (Saposhnikovia), Cangzhu (Atractylodes Rhizome), Gancao (Licorice), Shigao (Gypsum).
This formula treats headache due to Wind, Damp, and Heat. If Wind dominates, double Fangfeng and add Qianghuo (Notopterygium); if Damp dominates, double Cangzhu and add Baizhi (Angelica Dahurica); if Heat dominates, double Shigao and add Huangbai (Phellodendron); for Taiyang signs, add Gaoben (Ligusticum); for Yangming signs, add Shengma (Cimicifuga); for Shaoyang signs, add Chaihu (Bupleurum). Usually add a small amount of Chuanxiong (Ligusticum) to ascend to the temples.
Qianghuo Xuanqi Tang (Notopterygium Marvellous Selection Decoction)
Ingredients: Qianghuo (Notopterygium), Fangfeng (Saposhnikovia), Huangqin (Scutellaria), Gancao (Licorice).
This formula treats Taiyang Wind-Heat headache. For Shaoyang signs, add Chaihu (Bupleurum), Chuanxiong (Ligusticum); for Yangming signs, add Shengma (Cimicifuga), Baizhi (Angelica Dahurica). For severe Wind-Heat, add Bohe (Mint), Jingjie (Schizonepeta), Gaoben (Ligusticum); for interior accumulated heat, add Zhizi (Gardenia), Lianzi (Coptis); for frequent Toufeng (Head Wind) pain, add Manjingzi (Vittex Seed), Gaoben (Ligusticum); for pain upon exposure to cold, add Xixin (Asari), Chuanxiong (Ligusticum).
Xingshi Erchen Tang (Arisaema and Floating Stone Two-Aged Decoction) is Erchen Tang (Two-Aged Decoction) plus Danning (Gall-Bile Arisaema) and Shichangpu (Acorus).
This formula treats headache due to Phlegm-Fluid congealing in the Middle Jiao and rushing up to the forehead. For Wind, add Fangfeng (Saposhnikovia), Jingjie (Schizonepeta); for Fire, add Zhizi (Gardenia), Lianzi (Coptis); for Cold, add Xixin (Asari), Chuanxiong (Ligusticum); for fever and aversion to cold, add Qianghuo (Notopterygium); for forehead pain radiating to eyes, add Gange (Kudzu), Baizhi (Angelica Dahurica), Shengma (Cimicifuga); for alternating chills/fever, temple pain radiating to ears, add Chaihu (Bupleurum), Chuanxiong (Ligusticum).
Pingwei Erchen Tang (Stomach-Pacifying Two-Aged Decoction) is Erchen Tang (Two-Aged Decoction) combined with Pingwei San (Stomach-Pacifying Powder).
Frequent headache, commonly called Toufeng (Head Wind), originates from internal latent Phlegm accumulation and external exposure to Wind-Cold. If accompanied by nausea and fullness, it is surely due to Phlegm accumulation. I have used this formula combined with Baohe San (Harmonize and Preserve Powder), heavily adding Doukou (Cardamom), Shichangpu (Acorus), and Laifuzi (Radish Seed) to remove the root cause in the Stomach, preventing recurrence.
Daotan Tang (Phlegm-Resolving Decoction) - See Simulating Malaria section.
For headache with vomiting and nausea, this formula treats Phlegm-Fluid. For external Cold, add Qianghuo (Notopterygium), Xixin (Asari), Manjingzi (Vittex), Chuanxiong (Ligusticum), Gaoben (Ligusticum); for Wind, add Fangfeng (Saposhnikovia), Jingjie (Schizonepeta); for Summer-Heat, add Huanglian (Coptis), Huashi (Talc); for Wind-Damp, add Fangfeng (Saposhnikovia), Cangzhu (Atractylodes), Baizhi (Angelica Dahurica), Shichangpu (Acorus).
Kongxian Dan (Phlegm-Fluid Expelling Pill)
Ingredients: Kansui Radix (Gansui), Dajiei Radix (Daji), Mustard Seed (Baijiezi).
When Phlegm-Fluid lodges in the hypochondrium causing pain, named Xuan Yin (Suspension Fluid) or Zhi Yin (Branch Fluid), Shizao Tang (Ten Jujubes Decoction) is used. When Phlegm lodges in the Stomach and rushes up to the forehead causing pain, Kongxian Dan (Phlegm-Fluid Expelling Pill) is used. Both use Gansui (Kansui) and Daji (Dajiei); Shizao Tang uses Yuanhua (Genkwa) instead of Baijiezi (Mustard Seed), while Kongxian Dan uses Baijiezi (Mustard Seed) instead of Yuanhua (Genkwa). Both treat Phlegm-Fluid diseases; one pains the hypochondrium, the other the head, hence different actions of dispersing above and purging below.
Erchen Zhilian Danning Tang (Two-Aged Gardenia, Coptis, and Gall-Bile Arisaema Decoction) is Erchen Tang (Two-Aged Decoction) plus Zhizi (Gardenia), Lianzi (Coptis), and Danning (Gall-Bile Arisaema).
The previous clauses all describe Phlegm-Fluid; this one describes Phlegm-Fire rushing up. If there is an external cold-damage, add exterior-dispersing herbs to first expel the external pathogen.
Siwu Zhibai Tang (Four Substances Anemarrhena and Phellodendron Decoction) is Siwu Tang (Four Substances Decoction) plus Zimu (Anemarrhena) and Huangbai (Phellodendron).
This formula originally treats internal injury Yin-Fire rushing inward causing headache. Listed here for comparative study, they complement each other.
Shizao Tang (Ten Jujubes Decoction) - See Hypochondriac Pain.
Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) - See Thirst.
Tiaowei Chengqi Tang (Regulate the Stomach Order the Qi Decoction) - See Constipation.
External contraction headache strictly prohibits downward purging. However, for Yangming headache with aversion to heat rather than cold and solid stool, this formula is used for mild purging.