（大头痛 发颐 眉棱骨痛 眼眶痛附）
头为天象，诸阳经会焉。若六气外侵，精华内痹，郁于空窍、清阳不运，其痛乃作。经曰∶风气循风府而
上，为脑风。新沐中风，为首风。犯大寒，内至骨髓，为脑逆头痛。以上风寒痛。下虚上实，为肾厥头痛。
头痛耳鸣，九窍不利，为肠胃所生，头痛甚，脑尽痛，手足青至节，不治。阳气败绝，以上虚痛。条而列之，
有因风、因寒、因湿、因痰、因火、因郁热、因伏暑、因伤食、伤酒、伤怒、与气虚、血虚、及真头痛、偏
头痛、内风扰巅、肾虚水泛、肾虚气逆诸症。因风者恶风，川芎茶调散。因寒者恶寒，桂枝羌活汤。因湿者头
重，羌活胜湿汤。因痰者呕眩肢冷，为太阴痰厥头痛，半夏天麻白术汤。因火者齿痛，连翘、丹皮、桑叶、
羚羊角、山栀、薄荷、菊叶、苦丁茶。因郁热者心烦，清空膏加麦冬、丹参，或菊花散。因伏暑者口干，荷叶、
石膏、山栀、羚羊角、麦冬。因伤食者胸满，香砂枳术丸。因伤酒者气逆，葛花解酲汤。因伤怒者血逆，
沉香降气汤。气虚者脉大，补中汤加川芎、细辛。血虚者脉芤，或鱼尾上攻，眉尖后近发际为鱼尾。四物汤加
薄荷。真头痛，客邪犯脑，手足青至节，黑锡丹，炙百会穴。偏头痛屡发日久不痊，菊花茶调散、芎犀丸、
透顶散。内风扰巅者，筋惕，肝阳上冒，震动髓海，三才汤加牡蛎、阿胶、白芍、茯神、炒甘菊花。肾虚水泛
者，头痛如破，昏重不安，六味汤去丹皮，加沉香，更以七味丸、人参汤下。因肾虚气逆，为肾厥，玉真丸、
来复丹。外如雷头风，头痛起块，或鸣如雷震，清震汤。大头痛，头面尽肿，由天行时疫，甚则溃脓，普济消
毒饮。轻者发颐，肿耳前后，甘桔汤加薄荷、荆芥、鼠粘子、连翘、黄芩。眉棱骨痛，由风热外干，痰湿内郁，
选奇汤。眼眶痛，俱属肝经，肝虚见光则痛，生熟地黄丸。肝经停饮，痛不可开，昼
静夜剧，导痰汤。
东垣曰∶头痛每以风药治者，高巅之上，惟风可到，味之薄者，阴中之阳，自地升天者也。太阳头痛，
恶风寒，脉浮紧，川芎、羌活、独活、麻黄之类为主。少阳头痛，脉弦细，往来寒热，柴胡、黄芩为主。阳
明头痛，自汗寒热，脉浮缓长实，升麻、葛根、白芷、石膏为主。太阴头痛必有痰，体重腹痛，脉沉缓，苍
术、半夏、南星为主。少阴头痛，足寒气逆，为寒厥，脉沉细，麻黄附子细辛汤主之。厥阴头项痛，或吐涎
沫厥冷，脉浮缓，吴茱萸汤主之。太阴少阴二经，虽不上头，然痰与气逆壅于膈，头上气不得畅而为痛也。
此六经头痛之治也。
（大头痛、发颐、眉棱骨痛、眼眶痛附）
头为诸阳经汇聚之处。若六淫邪气外侵，体内精华闭塞，郁滞于空窍，导致清阳之气不能上升运化，疼痛便由此产生。医经记载：风邪沿着风府穴上行，称为脑风。刚洗完头受风，称为首风。遭受大寒侵袭，寒气深入骨髓，称为脑逆头痛。以上这些属于风寒引起的头痛。下焦虚损而上部实盛，称为肾厥头痛。头痛伴随耳鸣，九窍不通利，是由肠胃病变引起的；如果头痛剧烈，脑部全痛，手足青紫甚至到达关节，则属不治之症。阳气败绝，属于上部虚损的头痛。现将上述情况分条列出，包括因风、因寒、因湿、因痰、因火、因郁热、因伏暑、因伤食、伤酒、伤怒，以及气虚、血虚，还有真头痛、偏头痛、内风扰动头顶、肾虚水泛、肾虚气逆等各种证候。
因风邪所致者，恶风，用川芎茶调散治疗。因寒邪所致者，恶寒，用桂枝羌活汤治疗。因湿邪所致者，头部沉重，用羌活胜湿汤治疗。因痰邪所致者，呕吐眩晕、四肢冰冷，属于太阴痰厥头痛，用半夏天麻白术汤治疗。因火邪所致者，牙齿疼痛，药用连翘、丹皮、桑叶、羚羊角、山栀、薄荷、菊叶、苦丁茶。因郁热所致者，心烦，用清空膏加麦冬、丹参，或者菊花散治疗。因伏暑所致者，口干，药用荷叶、石膏、山栀、羚羊角、麦冬。因伤食所致者，胸脘胀满，用香砂枳术丸治疗。因伤酒所致者，气机上逆，用葛花解酲汤治疗。因暴怒所致者，血气上逆，用沉香降气汤治疗。气虚者脉象大而无力，用补中汤加川芎、细辛。血虚者脉象芤（中空），或者疼痛从鱼尾处向上攻冲，眉尖后方近发际处称为鱼尾，用四物汤加薄荷治疗。真头痛，是客邪侵犯脑部，手足青紫至关节，用黑锡丹，并灸百会穴。偏头痛反复发作日久不愈，用菊花茶调散、芎犀丸、透顶散治疗。内风扰动头顶者，筋脉跳动，肝阳上冒，震动髓海，用三才汤加牡蛎、阿胶、白芍、茯神、炒甘菊花。肾虚水泛者，头痛如裂，昏沉重着不安，用六味地黄汤去丹皮，加沉香，再用七味丸、人参汤送服。因肾虚气逆导致的肾厥，用玉真丸、来复丹治疗。外部如雷头风，头痛起块，或鸣响如雷震，用清震汤治疗。大头痛，头面全部肿胀，由天时疫毒引起，严重则溃烂流脓，用普济消毒饮治疗。轻者表现为发颐，耳前后肿胀，用甘桔汤加薄荷、荆芥、鼠粘子、连翘、黄芩。眉棱骨痛，由风热外袭，痰湿内郁引起，选用奇汤治疗。眼眶痛，均属于肝经病变，肝虚见光则痛，用生熟地黄丸治疗。肝经停聚水饮，疼痛剧烈无法睁眼，白天安静夜间加重，用导痰汤治疗。
李东垣说：治疗头痛多用风药，因为高处的巅顶，只有风药能到达，气味薄弱的药物，属于阴中之阳，能从地上升达天穹。太阳头痛，恶风怕冷，脉浮紧，以川芎、羌活、独活、麻黄等为主药。少阳头痛，脉弦细，往来寒热，以柴胡、黄芩为主药。阳明头痛，自汗、寒热交替，脉浮缓长实，以升麻、葛根、白芷、石膏为主药。太阴头痛必有痰，身体沉重腹痛，脉沉缓，以苍术、半夏、南星为主药。少阴头痛，足部寒冷气逆，属于寒厥，脉沉细，用麻黄附子细辛汤主治。厥阴头痛连及项部，或吐涎沫、四肢厥冷，脉浮缓，用吴茱萸汤主治。太阴和少阴两条经脉虽然不上达头部，但痰和气逆壅塞在膈部，导致头部气机不畅而疼痛。这就是六经头痛的治疗方法。
(Severe Headache, Parotitis, Pain of the Supraorbital Ridge, and Pain of the Eye Socket)
The head is the convergence point of all Yang meridians. If the Six Excesses (Six Qi) invade from outside, and the essence and nutrients become blocked internally, stagnating in the orifices and preventing the clear Yang from ascending and circulating, pain arises. The Classics state: Wind pathogens following the Fengfu point upward cause Brain Wind. Exposure to wind immediately after washing hair causes First Wind. Severe cold invading inwardly to the bone marrow causes Brain Reversal Headache. These above belong to headaches caused by Wind-Cold. Deficiency below and excess above constitute Kidney Reversal Headache. Headache accompanied by tinnitus and dysfunction of the nine orifices originates from the Stomach and Intestines; if headache is severe with whole-brain pain and cyanosis of hands and feet extending to the joints, it is incurable. Yang Qi exhaustion constitutes upper deficiency headache. Listed item by item, there are syndromes due to Wind, Cold, Dampness, Phlegm, Fire, Stagnant Heat, Hidden Summerheat, Food Injury, Alcohol Injury, Anger Injury, as well as Qi Deficiency, Blood Deficiency, True Headache, Migraine, Internal Wind disturbing the vertex, Kidney Deficiency with Water Flooding, and Kidney Deficiency with Qi Reversal.
For those due to Wind, characterized by aversion to wind, Chuanxiong Chatiao San (Ligusticum Chuanxiong Tea-Regulating Powder) is used. For those due to Cold, characterized by aversion to cold, Guizhi Qianghuo Tang (Cinnamon Twig and Notopterygium Decoction) is used. For those due to Dampness, characterized by heavy head, Qianghuo Shengshi Tang (Notopterygium Decoction for Overcoming Dampness) is used. For those due to Phlegm, characterized by vomiting, vertigo, and cold limbs, constituting Taiyin Phlegm-Reversal Headache, Banxia Tianma Baizhu Tang (Pinellia, Gastrodia, and Atractylodes Macrocephala Decoction) is used. For those due to Fire, characterized by toothache, herbs include Lianqiao (Forsythiae Fructus), Danpi (Moutan Cortex), Sangye (Mori Folium), Lingyangjiao (Saiga Tataricae Cornu), Zhizi (Gardeniae Fructus), Bohe (Menthae Haplocalycis Herba), Juye (Chrysanthemi Indici Flos), and Kudingcha (Ilicis Kudingae Folium). For those due to Stagnant Heat, characterized by mental restlessness, Qingkong Gao (Clear Empty Paste) added with Maidong (Ophiopogonis Radix) and Danshen (Salviae Miltiorrhizae Radix), or Juhua San (Chrysanthemum Powder), is used. For those due to Hidden Summerheat, characterized by dry mouth, herbs include Heye (Nelumbinis Folium), Shigao (Gypsum Fibrosum), Zhizi (Gardeniae Fructus), Lingyangjiao (Saiga Tataricae Cornu), and Maidong (Ophiopogonis Radix). For those due to Food Injury, characterized by chest fullness, Xiangsha Zhizhu Wan (Aucklandia and Amomum Pill for Strengthening the Spleen) is used. For those due to Alcohol Injury, characterized by rebellious Qi, Gegua Jiecheng Tang (Ardisiae Japonicae Flower Decoction for Resolving Intoxication) is used. For those due to Anger Injury, characterized by rebellious blood and Qi, Chenxiang Jiangqi Tang (Aquilariae Wood Decoction for Descending Rebellious Qi) is used. For Qi Deficiency, characterized by a large pulse, Buzhong Tang (Middle-Supplementing Decoction) added with Chuanxiong (Ligustici Chuanxiong Rhizoma) and Xixin (Asari Radix et Rhizoma) is used. For Blood Deficiency, characterized by a Kou pulse (scallion-stalk pulse) or pain attacking upwards from the "Fish Tail" (the area behind the eyebrow tip near the hairline), Siwu Tang (Four Substances Decoction) added with Bohe (Menthae Haplocalycis Herba) is used. For True Headache, where pathogenic factors invade the brain causing cyanosis of hands and feet to the joints, Heixi Dan (Black Lead Pill) is used, along with moxibustion on Baihui (GV20). For recurrent Migraine that persists for a long time, Juhua Chatiao San (Chrysanthemum Tea-Regulating Powder), Xiongxī Wan (Sinosaurus Horn Pill), and Touding San (Top-Penetrating Powder) are used. For Internal Wind disturbing the vertex, characterized by muscle twitching, Liver Yang rising and disturbing the Marrow Sea, Sancai Tang (Three Talents Decoction) added with Muli (Concha Ostreae), Ejiao (Colla Corii Asini), Baishao (Paeoniae Radix Alba), Fushen (Poria cum Radice et Ramis Pini), and fried Juhua (Chrysanthemi Flos) is used. For Kidney Deficiency with Water Flooding, characterized by headache as if splitting, heaviness, and restlessness, Liuwei Tang (Six-Ingredient Decoction) without Danpi (Moutan Cortex), added with Chenxiang (Aquilariae Lignum), is taken with Qiyi Wan (Seven-Ingredient Pill) and Renshen Tang (Ginseng Decoction). For Kidney Reversal due to Kidney Deficiency and Qi Reversal, Yuzhen Wan (Zhenzhu Mother Pill) and Laifu Dan (Restoring Life Pill) are used. Externally, for Leitoufeng (Thunderhead Wind) where headache presents with swelling or thunder-like roaring, Qingzhen Tang (Clearing and Purifying Decoction) is used. For Da Toutong (Great Headache) with total swelling of the head and face caused by epidemic toxins, which may suppurate, Puji Xiaodu Yin (Universal Benefit Detoxification Decoction) is used. For mild cases presenting as Fayi (Parotitis) with swelling around the ears, Ganjie Tang (Licorice and Platycodon Decoction) added with Bohe (Menthae Haplocalycis Herba), Jingjie (Schizonepetae Spica), Niubangzi (Arctii Fructus), Lianqiao (Forsythiae Fructus), and Huangqin (Scutellariae Radix) is used. For pain of the supraorbital ridge caused by external Wind-Heat and internal Damp-Phlegm stagnation, Xuanqi Tang (Select Extraordinary Decoction) is used. For pain of the eye socket, belonging to the Liver Meridian, pain upon exposure to light due to Liver Deficiency is treated with Shengshu Dihuang Wan (Raw and Prepared Rehmannia Pill). For fluid retention in the Liver Meridian causing severe pain preventing eye opening, worse at night than during the day, Daotan Tang (Expelling Phlegm Decoction) is used.
Li Dongyuan stated: Headaches are often treated with Wind-dispersing herbs because only Wind herbs can reach the high vertex; herbs with thin flavors are Yang within Yin, ascending from earth to heaven. Taiyang Headache, characterized by aversion to wind and cold and a floating-tight pulse, is primarily treated with Chuanxiong (Ligustici Chuanxiong Rhizoma), Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), and Mahuang (Ephedrae Herba). Shaoyang Headache, characterized by a string-taut-thin pulse and alternating chills and fever, is primarily treated with Chaihu (Bupleuri Radix) and Huangqin (Scutellariae Radix). Yangming Headache, characterized by spontaneous sweating, alternating chills and fever, and a floating-slow-long-excess pulse, is primarily treated with Shengma (Cimicifugae Rhizoma), Gegen (Puerariae Lobatae Radix), Baizhi (Angelicae Dahuricae Radix), and Shigao (Gypsum Fibrosum). Taiyin Headache must involve Phlegm, with heavy body and abdominal pain, and a sinking-slow pulse, primarily treated with Cangzhu (Atractylodis Rhizoma), Banxia (Pinelliae Rhizoma Preparatum), and Nanxing (Arisaematis Cum Bile). Shaoyin Headache, characterized by cold feet and rebellious Qi constituting Cold Reversal, with a sinking-thin pulse, is primarily treated with Ma Huang Fu Zi Xi Xin Tang (Ephedra, Aconite, and Asarum Decoction). Jueyin Headache involving the neck, or accompanied by salivation and cold limbs with a floating-slow pulse, is primarily treated with Wuzhuyu Tang (Evodiae Fructus Decoction). Although the Taiyin and Shaoyin meridians do not ascend to the head, Phlegm and rebellious Qi obstructing the diaphragm prevent Qi from flowing freely in the head, causing pain. This is the treatment for Headache of the Six Meridians.