秦子曰∶大头症，古书未载，近代独多。头面红肿，其大如斗，若肿在两颐，头上不肿
，名曰发颐，非大头症也。大头症，有外感，无内伤。
【大头痛之症】身发寒热，头面 肿，赤色 红，壅害言语，此三阳经湿热为患
大小传染，沿门相似，此天行湿毒症。若无传染，独一人自病，此起居不慎，偶触湿热之
气，人自感冒，《内经》所谓湿上甚为热，正此症也。
【大头痛之因】太阴司天，湿淫所胜；少阳司天，火淫所胜；阳明之胜，上行头目。
湿胜则肿，热胜则痛，湿热上甚，则头面 肿，大头之症作矣。
【大头痛之脉】必见浮洪。湿胜则浮；热胜则数。浮数宜汗，沉数宜清。浮大易愈，
【大头痛之治】宜羌活败毒散以散天气之邪；次用《普济》消毒饮，加酒煮大黄，以清
散热毒
羌独败毒散
羌活 独活 柴胡 前胡 桔梗 枳壳 川芎
湿胜肿大，加苍术、白芷；口干、脉大，加葛根、升麻，兼散阳明。
普济消毒饮
升麻 柴胡 陈皮 甘草 人参 黄连 黄芩 桔梗 玄参 连翘 马勃 大力子 僵
大便闭，加酒浸大黄。口渴，加石膏、天花粉。
头痛虽有气血虚者，然到底痛无补法，以但虚无邪，必不作痛；即气虚头痛，必是虚
而冒寒，然后作痛；血虚头痛，必是血虚有火，然后攻冲而痛。凡治病必先治其痛。如气
虚冒风寒，荆防芎苏饮，内服外熏，痛愈以四君子汤补气；血虚有火，知柏四物汤，痛止
，服当归补血汤。然头痛第一要详审胃家无滞者，可用上二法；若胸次欠适，即为痰饮凝滞
，又要平胃化滞，以头痛皆因胸前凝滞而起，胸前凝滞，则胃阳不能上布，易于感邪，故平
胃保和散，治头痛要着，无论内伤头痛，即外感之痛亦用之。以外感表邪，必要宣通胃阳，
方能作汗外解，故疏散胃滞，为发汗散邪妙诀。夫发汗散邪，人人知之，欲散外邪，先散胃
滞，使胃阳敷布作汗，人所不知也。
秦子说：大头症（以头面红肿为特征的疾病），古代医书未曾记载，近代却十分多见。头面部红肿，大如斗状；如果肿胀仅发生在两颊下颌部位，而头部不肿，称为“发颐”（腮腺炎类疾病），这不属于大头症。大头症，由外感邪气引起，没有内伤因素。
【大头痛的症状】身体出现恶寒发热，头面部肿胀，皮肤呈赤红色，咽喉壅塞导致言语困难，这是三阳经湿热邪气致病所致。病情具有传染性，沿门遍染，症状相似，这是天行湿毒疫病。如果没有传染性，仅一人独自发病，这是由于起居不慎，偶然触犯了湿热之气，人体自身感受外邪，《黄帝内经》所说的“湿气在上，甚则化为热”，正是指这种病症。
【大头痛的病因】太阴湿土司天之年，湿气淫盛；少阳相火司天之年，火气淫盛；阳明燥金偏胜时，邪气上行至头目。湿气偏胜则导致肿胀，热气偏胜则导致疼痛，湿热之邪上攻严重，则头面部肿胀，大头症便发作了。
【大头痛的脉象】必然见到浮洪脉。湿气偏胜则脉浮，热气偏胜则脉数。脉浮数适宜用发汗法，脉沉数适宜用清热法。脉浮大者容易治愈。
【大头痛的治疗】宜用羌活败毒散来疏散天气之邪；其次使用《普济消毒饮》，加入酒煮大黄，以清散热毒。
羌活败毒散
药材：羌活、独活、柴胡、前胡、桔梗、枳壳、川芎。
若湿气偏胜导致肿大，加苍术、白芷；若口干、脉大，加葛根、升麻，兼散阳明经邪气。
普济消毒饮
药材：升麻、柴胡、陈皮、甘草、人参、黄连、黄芩、桔梗、玄参、连翘、马勃、牛蒡子、僵蚕。
若大便闭结，加酒浸大黄。若口渴，加石膏、天花粉。
头痛虽然也有气血虚弱引起的，但归根结底头痛没有单纯的补益治法，因为如果只是虚无而无邪气，必定不会疼痛；即使是气虚引起的头痛，也必然是因虚而冒受寒邪，然后才发生疼痛；血虚引起的头痛，也必然是血虚伴有火热，然后才攻冲作痛。凡是治病，必须先治疗其疼痛。如果是气虚冒受风寒，可用荆防芎苏饮，内服并外用熏洗，疼痛缓解后服用四君子汤补气；如果是血虚伴有火热，可用知柏四物汤，疼痛停止后，服用当归补血汤。然而治疗头痛首要详细审察胃中是否有积滞，若无积滞，可使用上述两种方法；如果胸膈部感觉不适，即为痰饮凝滞，又需要平胃散化除滞气，因为头痛皆因胸前凝滞而起，胸前凝滞，则胃阳不能向上布散，易于感受邪气，所以平胃保和散是治疗头痛的关键方剂，无论是内伤头痛，还是外感引起的头痛都适用。因为外感表邪，必须宣通胃阳，才能出汗使邪气从体表解除，所以疏散胃中滞气，是发汗散邪的妙诀。人们都知道发汗可以散邪，但想要散除外邪，先要疏散胃中滞气，使胃阳敷布从而产生汗液，这一点人们却并不知晓。
Qin Zi said: Da Tou Zheng (Disease of Large Head, characterized by swelling and redness of the head and face) is not recorded in ancient texts but is very common in recent times. The head and face swell and become red, large as a dou (a unit of volume); if the swelling occurs only in the parotid regions (cheeks/jaw) without swelling on the head, it is called Fa Yi (Mumps/Parotitis), which does not belong to Da Tou Zheng. Da Tou Zheng is caused by external contraction and has no internal injury etiology.
[Symptoms of Severe Headache] The body presents with aversion to cold and fever, swelling of the head and face, reddish skin discoloration, pharyngeal congestion causing difficulty in speech; this is caused by damp-heat pathogenic factors affecting the Three Yang meridians. The condition is contagious, spreading from house to house with similar symptoms, which is known as Tian Xing Shi Du Bing (Epidemic Damp-Toxin Disease). If there is no contagion and only one person falls ill independently, it arises from careless daily living, accidentally encountering damp-heat qi, leading to personal external contraction. This corresponds to what the *Nei Jing* (Inner Canon) states: "Dampness above becomes severe heat," referring precisely to this syndrome.
[Etiology of Severe Headache] In years when Tai Yin (Too-Yin) governs the heaven, dampness prevails excessively; in years when Shao Yang (Lesser-Yang) governs the heaven, fire prevails excessively; when Yang Ming (Bright-Yang) is victorious, pathogens ascend to the head and eyes. Excessive dampness leads to swelling, excessive heat leads to pain. When damp-heat ascends severely, the head and face swell, and the disease of Da Tou Zheng manifests.
[Pulse Diagnosis of Severe Headache] The pulse must appear Floating and Surging (Fu Hong). Excessive dampness results in a Floating pulse; excessive heat results in a Rapid pulse. A Floating-Rapid pulse indicates suitability for sweating therapy; a Deep-Rapid pulse indicates suitability for clearing heat. A Floating-Large pulse suggests the disease is easy to cure.
[Treatment of Severe Headache] One should use Qiang Huo Bai Du San (Notopterygium Decoction to Overcome Toxins) to disperse weather-related pathogens; subsequently, use Pu Ji Xiao Du Yin (Universal Benefit Decoction to Eliminate Toxins) with Rhubarb boiled in wine added, to clear and dissipate heat-toxin.
Qiang Huo Bai Du San
Herbs: Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix), Chai Hu (Bupleuri Radix), Qian Hu (Peucedani Radix), Jie Geng (Platycodonis Radix), Zhi Ke (Aurantii Fructus Immaturus), Chuan Xiong (Ligustici Chuanxiong Rhizoma).
If dampness is excessive causing swelling, add Cang Zhu (Atractylodis Rhizoma) and Bai Zhi (Angelicae Dahuricae Radix); if there is dry mouth and a large pulse, add Ge Gen (Puerariae Lobatae Radix) and Sheng Ma (Cimicifugae Rhizoma) to simultaneously disperse Yang Ming pathogens.
Pu Ji Xiao Du Yin
Herbs: Sheng Ma (Cimicifugae Rhizoma), Chai Hu (Bupleuri Radix), Chen Pi (Citri Reticulatae Pericarpium), Gan Cao (Glycyrrhizae Radix et Rhizoma), Ren Shen (Ginseng Radix), Huang Lian (Coptidis Rhizoma), Huang Qin (Scutellariae Radix), Jie Geng (Platycodonis Radix), Xuan Shen (Scrophulariae Radix), Lian Qiao (Forsythiae Fructus), Ma Bo (Toxicarium Flos), Niu Bang Zi (Arctii Fructus), Jiang Can (Bombyx Batryticatus).
If stool is constipated, add Rhubarb soaked in wine. If thirsty, add Shi Gao (Gypsum Fibrosum) and Tian Hua Fen (Trichosanthis Radix).
Although headaches can be caused by deficiency of Qi and Blood, ultimately there is no pure tonification method for headache, because if there were only deficiency without pathogenic factors, pain would certainly not occur; even if the headache is due to Qi deficiency, it must be that deficiency allows invasion of cold pathogens, after which pain occurs; if the headache is due to Blood deficiency, it must be that blood deficiency is accompanied by fire, after which attacking and throbbing pain occurs. In treating any disease, one must first address the pain. If it is Qi deficiency with invasion of wind-cold, use Jing Fang Xiong Su Yin (Schizonepeta and Saposhnikovia Decoction with Ligusticum and Perilla), taken internally and used for external fumigation; after pain subsides, administer Si Jun Zi Tang (Four Gentlemen Decoction) to tonify Qi. If it is Blood deficiency with fire, use Zhi Bai Si Wu Tang (Anemarrhena, Phellodendron, and Four Substances Decoction); after pain stops, take Dang Gui Bu Xue Tang (Angelica Sinensis Decoction to Tonify Blood). However, the primary requirement in treating headache is to carefully examine whether there is stagnation in the Stomach. If there is no stagnation, the aforementioned two methods can be used; if the chest area feels uncomfortable, it indicates stagnation of phlegm-fluids, requiring Ping Wei San (Powder to Calm the Stomach) to resolve stagnation. This is because headaches all arise from stagnation in the chest; when the chest is stagnant, Stomach Yang cannot distribute upward, making one susceptible to pathogens. Therefore, Ping Wei Bao He San (Powder to Calm the Stomach and Preserve Harmony) is a key formula for treating headaches, applicable to both internal injury headaches and those caused by external contraction. Because external contracted exterior pathogens require the unblocking of Stomach Yang to induce sweating and release pathogens from the exterior, dispersing Stomach stagnation is the excellent secret for inducing sweat and scattering pathogens. Everyone knows that sweating scatters pathogens, but few know that to scatter exterior pathogens, one must first disperse Stomach stagnation, allowing Stomach Yang to distribute and generate sweat.