夫大头痛者虽为在身在上热邪伏于已又感天地四时非节瘟疫之气所着所以成此
疾。至于溃裂脓出。而又染他人。所以谓之疫疠也。大抵足阳明邪热大甚资实。少阳相火为
之炽多。在少阳或在阳明。甚则逆传太阳视其肿势在何部分。随其经而取之湿热为肿。木盛
为痛。此邪发于首。多在两耳前后所先见出者为主为根。治之宜早。药不宜速。恐过其病。
上热未除。中寒已作。有伤人命矣。此疾是自内而之外也。是为血病。况头部受邪。现见于
无形之处。至高之分。当先缓而后急。先缓者。谓邪气在上所着无形之分。既着无形所传
无定。若用重剂大泻之。则其邪不去。反过其病矣。虽用缓药。若急服之。或食前或顿服。
咸失缓之体。则药不能腾升。徐溃无形之邪。或药性味形状拟象服饵。皆须不离缓体。及
寒
药或炒或酒浸之类皆是也。后急者。谓前缓剂已经高分。泻邪气入于中。是到阴部入于中。
染于内之有形质之所。若药不速去。反损阴分。此中治却为客热所当急也。治客以急。此之
谓也。治主以缓。先缓谓也。谓阳邪在上。阴邪在下。各为本家病。不从先后错其缓急。不
惟不能解其纷。而复致其乱矣。此所以治主当缓治客当急。谓阳分受阳邪。阴分受阴邪者主
也
。阳分受阴邪阴分受阳邪者客也。凡所谓急者。当急去之。此治客以急也。假令少阳阳明之
为病。少阳者。谓邪出于耳前后也。阳明者。首面大肿也。先以黄芩黄连甘草通炒锉煎少少
不住服呷之。或一剂毕。再用大黄或酒浸或煨。又以鼠粘子新瓦上炒。 咀煎成去渣。纳芒硝
各等分。亦时时呷之。当食后用。徐得微利。并邪气已。只服前药。如不已。再服后药。根据
前次第用之。取利已却止。如阳明渴者加石膏。少阳渴者加栝蒌根汤。阳明行经。加升麻葛
根芍药之类。选而加之。太阳行经。加羌活荆芥防风之类。选而加之。并与上药相合用之。
不可独用。散者散也。此一节亦见病机气宜。治洪长伏三脉风痫惊痫发狂。恶人与火者。灸
第三 第九 。服局方妙香丸。以针投眼子透。令水内浸少时服之。如本方法。治弦细缓三
脉。诸痫似狂。李和南五生丸。大凡治杂病先调其气。次疗诸疾无损胃气。是其要也。若血
受病。亦先调气。谓气不调。则血不行。又气为之纲夫也。夫不唱妇不随也。如妇人病经先
柴胡以行经之表。次四物以行经之里。亦先气而后血也。不能饮而渴。不能食而小便黄或涩
。皆因胃气虚而生热。有形之物不入火炎上而渴。戊就癸而化。所以小便黄赤如枣汁。法当
补胃以钱仲阳（白术散）。干葛木香藿香等药治之。
上焦渴。小便自利（白虎汤）。
中焦渴。大小便不利。（调胃承气汤）。
下焦渴。小便赤涩。大便不利。（大承气汤）。
大头痛这种病，虽然是因为身体上部有热邪潜伏，但又感受了天地四时不合节令的瘟疫之气而感染，所以才形成这种疾病。至于病情发展到溃烂流脓，并且传染给他人，所以称之为疫疠。大致来说，足阳明经邪热极盛且体质充实；少阳相火炽盛的情况较多。病位或在少阳经，或在阳明经，严重时则逆传至太阳经。观察肿胀的部位在哪个部分，就顺着该经脉进行治疗。湿热导致肿胀，肝木过盛导致疼痛。这种邪气发于头部，多以两耳前后最先出现症状的地方作为病根。治疗应当及早进行，用药不宜过猛过快，恐怕药力超过了病情的需要。导致上部的热邪尚未清除，中焦的寒邪已经产生，这会伤害人的性命。这种疾病是从内部向外部发展的，属于血分病变。况且头部受邪，显现于无形的高处，位置极高。治疗应当先缓后急。所谓“先缓”，是指邪气附着在上部无形的部位，既然附着在无形之处，其传变就没有定所。如果使用重剂猛烈攻下，那么邪气不能去除，反而会使病情加重。即使使用缓和的药物，如果急于服用，或者在饭前一次性顿服，都失去了“缓”的本意，导致药力不能升腾，缓慢地消散无形的邪气。或者药物的性味形状模拟意象来服用，都必须不离“缓”的原则。以及寒凉药物经过炒制或用酒浸泡等处理，都是这种方法。所谓“后急”，是指前面的缓剂已经将药力送达高位，将邪气泻入中部，这是到达阴部进入体内，沾染于内部的有形实质之所。如果药力不迅速祛除邪气，反而会损伤阴分。此时对于客邪的治疗应当急切，这就是用急法治疗客邪的道理。治疗主病用缓法，这就是所谓的“先缓”。意思是阳邪在上部，阴邪在下部，各自是本经的病证，如果不按照先后顺序错乱其缓急，不仅不能解开纷乱的病机，反而会导致混乱。这就是为什么治疗主病应当缓，治疗客邪应当急。意思是阳分受阳邪、阴分受阴邪的是主病；阳分受阴邪、阴分受阳邪的是客邪。凡是称为“急”的情况，应当急切地祛除它，这就是用急法治疗客邪。假如是少阳和阳明经的疾病：少阳病，是指邪气出于耳的前后；阳明病，是指头面部严重肿胀。先用黄芩、黄连、甘草共同炒制锉碎煎煮，少量不停地呷服。或者一剂服完后，再用大黄，或者用酒浸，或者煨制。又用鼠粘子（牛蒡子）在新瓦上炒制，咀嚼后煎煮成汤去渣，加入芒硝，各取等分。也时时呷服。应当在饭后服用，慢慢得到轻微的腹泻，直到邪气已尽。只服用前面的药，如果病不止，再服用后面的药。根据前面的次序使用，取得通便效果后就停止。如果阳明病口渴，加石膏；少阳病口渴，加栝蒌根汤。如果是阳明经行经之药，加升麻、葛根、芍药之类，选择加入。如果是太阳经行经之药，加羌活、荆芥、防风之类，选择加入。并与上面的药物配合使用，不可单独使用。散法就是发散的意思。这一节也见于《病机气宜保命集》中关于治疗洪、长、伏三种脉象的风痫、惊痫、发狂，恶人与火的病症，灸第三椎和第九椎穴。服用局方妙香丸，将针插入药丸的眼孔中穿透，让水浸泡片刻后服用。如同原本的方法。治疗弦、细、缓三种脉象，各种癫痫类似发狂的症状，用李和南五生丸。大凡治疗杂病，先调理气机，其次治疗各种疾病，不损伤胃气，这是关键所在。如果血分受病，也先调气，因为气不调，血就不能运行。气又是血的纲领，就像丈夫不倡导，妻子就不会跟随一样。如妇人月经病，先用柴胡以疏通经络表层的郁滞，次用四物汤以疏通经络里层的郁滞，也是先气而后血。如果不能饮水而口渴，不能进食而小便黄或涩滞，都是因为胃气虚弱而生热。有形的食物无法进入，火炎向上而导致口渴，戊土（胃）就癸水（肾）而化。所以小便黄赤像枣汁一样。治法应当补胃，用钱仲阳的白术散，干葛、木香、藿香等药物治疗。
上焦口渴，小便自利，用白虎汤。
中焦口渴，大小便不利，用调胃承气汤。
下焦口渴，小便赤涩，大便不利，用大承气汤。
Da Tou Tong (Great Headache) is a disease caused not only by latent heat pathogens in the upper body, but also by contracting epidemic qi from heaven and earth that does not conform to the seasonal rhythms. When it progresses to ulceration with pus discharge and infects others, it is called Yi Li (Epidemic Pestilence). Generally speaking, when the pathogenic heat of the Foot-Yangming Meridian is extremely severe and the constitution is full, or when the Ministerial Fire of Shaoyang is blazing, the disease may reside in Shaoyang or Yangming. In severe cases, it may transmit reversely to Taiyang. One should observe which part of the body is swollen and treat according to the affected meridian. Damp-heat causes swelling, while excessive Wood (Liver/Gallbladder) causes pain. This pathogen originates in the head, usually taking the area around the ears as the root where symptoms first appear. Treatment should be initiated early, and medication should not be administered too rapidly or heavily, lest the medicinal force exceed the pathology. This could result in the upper heat remaining uneliminated while middle jiao cold arises, potentially causing death. This disease develops from the interior to the exterior and involves blood pathology. Since the head is the highest part of the body and the pathogen manifests in formless regions, treatment should proceed from slow/gentle to rapid/forceful. "Slow" refers to addressing the formless pathogen in the upper region; since its transmission is不定 (indeterminate), using heavy purgatives will fail to remove the pathogen and may worsen the condition. Even with mild herbs, if taken hastily, on an empty stomach, or all at once, the "slow" principle is lost, preventing the medicine from ascending to slowly dissipate the formless pathogen. The nature, flavor, and shape of the herbs, as well as processing methods like stir-frying or wine-soaking for cold-natured herbs, must adhere to this gentle approach. "Rapid" follows the "slow"; after the gentle formula reaches the high regions and drains pathogenic qi into the middle, it enters the yin regions and internal solid structures. If the medicine does not act swiftly to expel the pathogen here, it may damage the yin substation. Thus, treating the "guest" pathogen requires urgency. Treating the "host" (primary) condition requires slowness. This distinction lies in whether yang pathogens affect yang branches (host) or yin pathogens affect yang branches (guest). Urgency is applied to guests; slowness to hosts. For example, in Shaoyang and Yangming diseases: Shaoyang disease involves pathogens emerging around the ears; Yangming disease involves severe swelling of the head and face. Initially, use Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), and Gan Cao (Glycyrrhizae Radix et Rhizoma), stir-fried together, crushed, and decocted. Take small sips continuously. After one dose, use Da Huang (Rhei Radix et Rhizoma), either wine-soaked or roasted, along with Niu Bang Zi (Arctii Fructus) stir-fried on a new tile. Decoct, strain, and add Mang Xiao (Natrii Sulfas) in equal parts. Sip frequently after meals until slight diarrhea occurs, indicating pathogen expulsion. Continue with the initial formula; if ineffective, proceed to the second formula. Follow this sequence and stop once bowel movements are achieved. If Yangming disease presents with thirst, add Shi Gao (Gypsum Fibrosum). If Shaoyang disease presents with thirst, add Gua Lou Gen (Trichosanthis Radix). For Yangming meridian involvement, add Sheng Ma (Cimicifugae Rhizoma), Ge Gen (Puerariae Lobatae Radix), and Bai Shao (Paeoniae Radix Alba) as appropriate. For Taiyang meridian involvement, add Qiang Huo (Notopterygii Rhizoma et Radix), Jing Jie (Schizonepetae Herba), and Fang Feng (Saposhnikoviae Radix) as appropriate. Combine these with the primary formulas; do not use them alone. The method of dispersal is discussed in *Bing Ji Qi Yi Bao Ming Ji* regarding wind epilepsy, fright epilepsy, mania, aversion to people and fire, associated with Hong, Chang, and Fu pulses. Moxibustion is applied to the 3rd and 9th vertebrae. Administer Ju Fang Miao Xiang Wan (Official Formulation Wonderful Fragrance Pill), piercing it with a needle and soaking it in water briefly before ingestion. For Xian, Xi, and Huan pulses with epilepsy resembling madness, use Li He Nan Wu Sheng Wan (Li He's Five Raw Ingredients Pill). Generally, treating miscellaneous diseases requires regulating qi first, then treating specific ailments without damaging Stomach qi, which is crucial. If blood is diseased, regulate qi first, as stagnant qi prevents blood circulation; qi acts as the commander of blood. Similar to women's menstrual disorders, Chai Hu (Bupleuri Radix) is used first to release the exterior of the meridians, followed by Si Wu Tang (Four Substances Decoction) to nourish the interior, reflecting the priority of qi over blood. Thirst without ability to drink, inability to eat, and yellow or obstructed urine indicate Stomach qi deficiency generating heat. Fire flares upward causing thirst due to the failure of Earth (Stomach) to transform Water (Kidney). Urine becomes yellow-red like date juice. The treatment should tonify the Stomach using Qian Zhong Yang's Bai Zhu San (Atractylodis Macrocephalae Powder) with Gan Ge (Puerariae Radix), Mu Xiang (Aucklandiae Radix), and Huo Xiang (Agastaches Herba).
Upper Jiao thirst with free urination: Bai Hu Tang (White Tiger Decoction).
Middle Jiao thirst with difficulty in both urination and defecation: Tiao Wei Cheng Qi Tang (Regulate the Stomach and Direct the Qi Decoction).
Lower Jiao thirst with red, scanty, painful urination and constipation: Da Cheng Qi Tang (Major Order the Qi Decoction).