1.头痛痰热风湿气, 或兼气血虚而疼, 在右属气多痰热, 左属血少
更属风, 因风眩晕头风痛, 热晕烦渴火上攻, 气郁不伸痰呕吐, 湿则
重痛虚动增.
【注】头痛, 属痰, 属热, 属风, 属湿, 属气, 或兼气虚, 血虚. 因
风而痛, 谓之头风, 必眩晕. 因热而痛晕者, 则烦渴. 因气郁而痛晕
者,则志意不伸. 因痰而痛晕者, 则呕吐痰涎. 因湿而痛晕者, 则头
重不起. 因虚而痛晕者, 动则更痛更晕也.
2.真头脑痛朝夕死, 手足厥逆至节青, 泻多眩晕时时冒, 头猝大痛
目瞀凶.
【注】真头痛, 痛连脑内, 手足青冷至肘膝之节, 朝发夕死. 凡头痛
眩晕, 时时迷冒, 及头目猝然大痛, 目视不见, 或泻多之后, 皆凶证
也.
荜苃散 芎芷石膏汤
3.头风?? 鼻热荜苃, 湿盛瓜蒂入茶茗, 风盛日久三圣散, 内服芎芷
石膏灵. 芎芷石膏菊羌??, 苦加细辛风防荆, 热加栀翘芩薄草, 便秘
尿红消黄攻.
【注】一切头风兼热者, 以荜苃散?? 鼻. 即荜苃一味为末, 用猪胆
汁拌过?? 之, 作嚏立愈. 一切头风兼湿者, 以瓜蒂, 松萝茶, 二味
为末,?? 之出黄水立愈. 头风风盛时发, 日久不愈, 则多令人目昏,
以三圣散?? 之, 方在中风门内. 用芎芷石膏汤, 即芎, 芷, 石膏,
菊花, 羌活,?? 本也. 苦痛者加细辛. 风盛目昏加防风, 荆芥穗. 热
盛加栀子, 连翘, 黄芩, 甘草. 大便秘小便赤加消, 黄, 攻之自愈也
.
茶调散 清震汤 滚痰丸 人参芎附汤
4.风热便利茶调散, 雷头荷叶苍与升, 痰热滚痰芎作引, 虚寒真痛
附参芎.
【注】雷头风痛, 头面疙瘩, 耳闻雷声, 宜清震汤, 即荷叶, 苍术,
升麻也. 人参芎附汤, 即人参, 川芎, 川附也.
芎犀丸
5.偏正头风芎犀丸, 血虚四物薄羌天, 气虚补中加芎细, 气逆降气
黑锡丹.
【注】血虚, 面少血色, 或久脱血也. 天, 天麻也. 降气, 苏子降气
汤也.
芎麻汤 半夏白术天麻汤
6.欲吐晕重风痰痛, 芎麻汤下白丸宁, 虚者六君耆干柏, 天麻麴蘖
泽苍同.
【注】麻, 天麻也. 白丸, 青州白丸子也. 虚者, 谓风痰兼气虚者,
宜半夏白术天麻汤, 即六君子加黄耆, 干姜, 黄柏, 天麻, 神麴, 麦
蘖,泽泻, 苍术也.
荆穗四物汤
7.头晕头痛同一治, 血虚物穗气补中, 气血两虚十全补, 上盛下虚
黑锡灵.
【注】头晕之虚实寒热诸证, 同乎头痛一治法也. 其有因血虚, 宜用
荆穗四物汤, 即当归, 川芎, 白芍, 熟地黄, 荆芥穗也. 气虚, 宜用
补中益气汤. 气血两虚, 宜用十全大补汤. 上盛下虚, 宜用黑锡丹.
1. 头痛可由痰、热、风、湿、气滞引起，或者兼有气血虚弱而疼痛。右侧头痛多属气滞和痰热，左侧头痛多属血少且兼受风邪。因风邪导致的眩晕和头风痛，因热邪导致的眩晕则伴有烦躁口渴（火热上攻），因气机郁结不舒导致的眩晕则伴有呕吐痰涎，因湿邪导致的眩晕则头部沉重疼痛，因虚证导致的眩晕则在活动时加重。
【注】头痛，属于痰、热、风、湿、气滞，或者兼有气虚、血虚。因风邪引起的疼痛，称为头风，必然伴有眩晕。因热邪引起疼痛和眩晕的，则伴有烦躁口渴。因气机郁结引起疼痛和眩晕的，则意志消沉、精神不振。因痰饮引起疼痛和眩晕的，则呕吐痰涎。因湿邪引起疼痛和眩晕的，则头部沉重难以抬起。因虚证引起疼痛和眩晕的，活动后疼痛和眩晕会加剧。
2. 真头痛（疼痛连及脑内）早晨发作晚上死亡，手足厥冷青紫直至肘膝关节，腹泻过多导致眩晕并时常昏蒙，头部突然剧烈疼痛且视物模糊为凶险之证。
【注】真头痛，疼痛牵连脑内，手足青冷直到肘膝关节，早晨发病晚上死亡。凡是头痛眩晕，时常迷乱昏蒙，以及头目突然剧烈疼痛，眼睛看不见东西，或者在腹泻过多之后出现的症状，都是凶险的证候。
荜苃散 芎芷石膏汤
3. 治疗头风兼鼻热的用荜苃散，湿盛者用瓜蒂加入茶茗中，风盛日久不愈的用三圣散，内服芎芷石膏汤有效。芎芷石膏汤由川芎、白芷、石膏、菊花、羌活、藁本组成；若疼痛剧烈加细辛，风盛加防风、荆芥穗，热盛加栀子、连翘、黄芩、薄荷、甘草，大便秘结、小便红赤则加大黄、芒硝攻下自愈。
【注】一切头风兼有热邪的，用荜苃散吹鼻。即单味荜苃研成粉末，用猪胆汁拌过后吹入鼻中，打喷嚏后立即痊愈。一切头风兼有湿邪的，用瓜蒂、松萝茶两味药研成粉末，吹入鼻中流出黄水立即痊愈。头风风邪盛时发作，日久不愈，常令人目昏，用三圣散吹鼻，方剂在中风门内。使用芎芷石膏汤，即川芎、白芷、石膏、菊花、羌活、藁本。疼痛剧烈者加细辛。风盛目昏加防风、荆芥穗。热盛加栀子、连翘、黄芩、甘草。大便秘结、小便赤红加大黄、芒硝攻下即可自愈。
茶调散 清震汤 滚痰丸 人参芎附汤
4. 风热兼大便通畅的用茶调散，雷头风（头面起疙瘩，耳闻如雷声）用荷叶、苍术、升麻组成的清震汤，痰热用滚痰丸以川芎为引，虚寒真头痛用人参、川芎、附子组成的人参芎附汤。
【注】雷头风疼痛，头面出现疙瘩，耳朵听到像雷声一样的声音，宜用清震汤，即荷叶、苍术、升麻组成。人参芎附汤，即人参、川芎、川附子组成。
芎犀丸
5. 偏正头风用芎犀丸，血虚用四物汤加薄荷、羌活、天麻，气虚用补中益气汤加川芎、细辛，气逆用降气的黑锡丹。
【注】血虚，面色少血色，或者是长期失血。天，指天麻。降气，指苏子降气汤。
芎麻汤 半夏白术天麻汤
6. 想要呕吐、头晕沉重、风痰引起的头痛，用芎麻汤送服青州白丸子可安宁。虚证者用六君子汤加黄芪、干姜、黄柏，再加天麻、神曲、麦芽、泽泻、苍术同用。
【注】麻，指天麻。白丸，指青州白丸子。虚证，指风痰兼有气虚者，宜用半夏白术天麻汤，即六君子汤加黄芪、干姜、黄柏、天麻、神曲、麦芽、泽泻、苍术组成。
荆穗四物汤
7. 头晕和头痛治疗方法相同，血虚用荆穗四物汤，气虚用补中益气汤，气血两虚用十全大补汤，上盛下虚用黑锡丹灵验。
【注】头晕的虚实寒热各种证候，与头痛的治疗方法相同。其中有因血虚的，宜用荆穗四物汤，即当归、川芎、白芍、熟地黄、荆芥穗组成。气虚，宜用补中益气汤。气血两虚，宜用十全大补汤。上盛下虚，宜用黑锡丹。
1. Headache may be caused by phlegm, heat, wind, dampness, or qi stagnation, or it may be accompanied by deficiency of qi and blood. Right-sided headache mostly belongs to qi stagnation and phlegm-heat, while left-sided headache mostly belongs to blood deficiency with wind pathogen. Dizziness and headache due to wind are called "head wind" (Toufeng); dizziness due to heat is accompanied by irritability and thirst (due to fire attacking upwards); dizziness due to qi depression is accompanied by vomiting of phlegm-saliva; dizziness due to dampness presents as heavy and painful head; dizziness due to deficiency worsens upon movement.
[Note] Headache belongs to phlegm, heat, wind, dampness, or qi stagnation, or is accompanied by qi deficiency and blood deficiency. Pain caused by wind is called "head wind" (Toufeng) and must be accompanied by dizziness. Pain and dizziness caused by heat are accompanied by irritability and thirst. Pain and dizziness caused by qi depression are accompanied by a depressed spirit and lack of vitality. Pain and dizziness caused by phlegm are accompanied by vomiting of phlegm-saliva. Pain and dizziness caused by dampness present as a heavy head that is difficult to lift. Pain and dizziness caused by deficiency worsen in pain and dizziness upon movement.
2. True headache (Zhen Toutong), where pain extends into the brain, leads to death if onset is in the morning and persists until evening; cold limbs turning blue up to the elbow and knee joints indicate a critical condition. Excessive diarrhea leading to dizziness and frequent fainting, or sudden severe headache with blurred vision, are ominous signs.
[Note] True headache (Zhen Toutong) involves pain extending into the brain, with cold and blue limbs reaching the elbows and knees, leading to death from morning onset to evening. Any case of headache and dizziness with frequent confusion and fainting, sudden severe pain in the head and eyes with loss of vision, or symptoms appearing after excessive diarrhea, are all ominous syndromes.
Bibi San (Bi Ba Powder) | Xiong Zhi Shi Gao Tang (Ligusticum, Angelica Dahurica, and Gypsum Decoction)
3. For head wind with nasal heat, use Bibi San; for excess dampness, use Citrulli Fructus Seed (Gua Di) added to tea; for wind excess persisting for a long time, use San Sheng San (Three Holy Powders); internally, Xiong Zhi Shi Gao Tang is effective. Xiong Zhi Shi Gao Tang consists of Chuanxiong Rhizome (Chuan Xiong), Angelicae Dahuricae Radix (Bai Zhi), Gypsum Fibrosum (Shi Gao), Chrysanthemi Flos (Ju Hua), Notopterygii Rhizoma et Radix (Qiang Huo), and Ligustici Rhizoma (Cao Ben). If pain is severe, add Asari Radix (Xi Xin); if wind is excessive with blurred vision, add Saposhnikoviae Radix (Fang Feng) and Schizonepetae Spica (Jing Jie Sui); if heat is excessive, add Gardeniae Fructus (Zhi Zi), Forsythiae Fructum (Lian Qiao), Scutellariae Radix (Huang Qin), Menthae Haplocalycis Herba (Bo He), and Glycyrrhizae Radix et Rhizoma (Gan Cao); if constipation and red urine occur, use Rhei Radix et Rhizoma (Da Huang) and Mirabilite (Mang Xiao) to purge and restore health.
[Note] For all cases of head wind with heat, use Bibi San insufflated into the nose. This is single-ingredient Biba powder mixed with pig bile juice and insufflated, causing sneezing and immediate cure. For all cases of head wind with dampness, use Citrulli Fructus Seed (Gua Di) and Poria Cocos (Song Luo Cha) powdered and insufflated, draining yellow fluid for immediate cure. When head wind flares due to wind excess and persists for a long time, it often causes blurred vision; use San Sheng San insufflated into the nose (formula found in the Stroke section). Use Xiong Zhi Shi Gao Tang, which consists of Chuanxiong Rhizome (Chuan Xiong), Angelicae Dahuricae Radix (Bai Zhi), Gypsum Fibrosum (Shi Gao), Chrysanthemi Flos (Ju Hua), Notopterygii Rhizoma et Radix (Qiang Huo), and Ligustici Rhizoma (Cao Ben). Add Asari Radix (Xi Xin) for severe pain. Add Saposhnikoviae Radix (Fang Feng) and Schizonepetae Spica (Jing Jie Sui) for wind excess and blurred vision. Add Gardeniae Fructus (Zhi Zi), Forsythiae Fructum (Lian Qiao), Scutellariae Radix (Huang Qin), and Glycyrrhizae Radix et Rhizoma (Gan Cao) for heat excess. Add Rhei Radix et Rhizoma (Da Huang) and Mirabilite (Mang Xiao) for constipation and red urine to purge and achieve self-healing.
Cha Tiao San (Tea-Powdering Powder) | Qing Zhen Tang (Clear Shock Decoction) | Gun Tan Wan (Rolling Phlegm Pill) | Renshen Xiong Fu Tang (Ginseng, Ligusticum, and Aconite Decoction)
4. For wind-heat with normal bowel movements, use Cha Tiao San; for Lei Tou Feng (Thunder-head Wind, characterized by lumps on head/face and hearing thunder-like sounds), use Qing Zhen Tang composed of Nelumbinis Folium (He Ye), Atractylodis Rhizoma (Cang Zhu), and Cimicifugae Rhizoma (Sheng Ma); for phlegm-heat, use Gun Tan Wan with Chuanxiong Rhizome as a guide; for deficiency-cold true headache, use Renshen Xiong Fu Tang composed of Ginseng Radix et Rhizoma (Renshen), Chuanxiong Rhizome (Chuan Xiong), and Aconiti Lateralis Radix Praeparata (Chuan Fu).
[Note] Lei Tou Feng (Thunder-head Wind) involves pain with lumps on the head and face, and auditory sensations like thunder; Qing Zhen Tang is indicated, composed of Nelumbinis Folium (He Ye), Atractylodis Rhizoma (Cang Zhu), and Cimicifugae Rhizoma (Sheng Ma). Renshen Xiong Fu Tang is composed of Ginseng Radix et Rhizoma (Renshen), Chuanxiong Rhizome (Chuan Xiong), and Aconiti Lateralis Radix Praeparata (Chuan Fu).
Xiong Xi Wan (Ligusticum and Rhinoceros Horn Pill)
5. For lateral and central head wind, use Xiong Xi Wan; for blood deficiency, use Si Wu Tang (Four Substances Decoction) plus Menthae Haplocalycis Herba (Bo He), Notopterygii Rhizoma et Radix (Qiang Huo), and Gastrodiae Rhizoma (Tian Ma); for qi deficiency, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) plus Chuanxiong Rhizome (Chuan Xiong) and Asari Radix (Xi Xin); for rebellious qi, use Hei Xi Dan (Black Tin Pill) to descend qi.
[Note] Blood deficiency presents with pale complexion or follows prolonged blood loss. Tian refers to Gastrodiae Rhizoma (Tian Ma). Jiang Qi refers to Su Zi Jiang Qi Tang (Perilla Fruit Descending Qi Decoction).
Xiong Ma Tang (Ligusticum and Gastrodia Decoction) | Ban Xia Bai Zhu Tian Ma Tang (Pinellia, Atractylodes Macrocephala, and Gastrodia Decoction)
6. For nausea, heavy dizziness, and headache due to wind-phlegm, administer Qingzhou Bai Wan Wan (Qingzhou White Pill) with Xiong Ma Tang to calm symptoms. For deficiency patterns, use Liu Jun Zi Tang (Six Gentlemen Decoction) plus Astragali Radix (Huang Qi), Zingiberis Rhizoma (Gan Jiang), Phellodendri Cortex (Huang Bo), Gastrodiae Rhizoma (Tian Ma), Saccharomyces (Shen Qu), and Hordeum Vulgare Germinatum (Mai Ya), along with Alismatis Rhizoma (Ze Xie) and Atractylodis Rhizoma (Cang Zhu).
[Note] Ma refers to Gastrodiae Rhizoma (Tian Ma). Bai Wan refers to Qingzhou Bai Wan Wan (Qingzhou White Pill). Deficiency pattern refers to wind-phlegm accompanied by qi deficiency; Ban Xia Bai Zhu Tian Ma Tang is indicated, which is Liu Jun Zi Tang plus Astragali Radix (Huang Qi), Zingiberis Rhizoma (Gan Jiang), Phellodendri Cortex (Huang Bo), Gastrodiae Rhizoma (Tian Ma), Saccharomyces (Shen Qu), Hordeum Vulgare Germinatum (Mai Ya), Alismatis Rhizoma (Ze Xie), and Atractylodis Rhizoma (Cang Zhu).
Jing Sui Si Wu Tang (Schizonepeta Four Substances Decoction)
7. Dizziness and headache share the same treatment principle: for blood deficiency, use Jing Sui Si Wu Tang; for qi deficiency, use Bu Zhong Yi Qi Tang; for dual qi and blood deficiency, use Shi Quan Da Bu Tang (Ten Great Tonifying Decoction); for upper excess and lower deficiency, Hei Xi Dan (Black Tin Pill) is effective.
[Note] The various deficiency-excess, cold-heat syndromes of dizziness are treated similarly to headache. For those due to blood deficiency, Jing Sui Si Wu Tang is indicated, composed of Angelicae Sinensis Radix (Dang Gui), Chuanxiong Rhizome (Chuan Xiong), Paeoniae Radix Alba (Bai Shao), Rehmanniae Radix Praeparata (Shu Di Huang), and Schizonepetae Spica (Jing Jie Sui). For qi deficiency, Bu Zhong Yi Qi Tang is indicated. For dual qi and blood deficiency, Shi Quan Da Bu Tang is indicated. For upper excess and lower deficiency, Hei Xi Dan is indicated.