大意
头为天象。六腑清阳之气。五脏精华之血。皆会于此。惟经气上逆。干犯清道。不得营运。则壅遏为痛。（微论）
内因
自外入者。风寒暑湿之邪。自内发者。气血痰郁之异。（玉机）或蔽覆其清明。或瘀塞其经络。与气相搏。脉满
而痛。（汇补）
外候
头脑痛连两额属太阳。头额痛连目齿属阳明。头角痛连耳根属少阳。太阳穴痛属脾虚。巅顶痛属肾。目
系痛属肝。（汇补）
痛分内外
外感头痛。如破如裂。无有休歇。内伤头痛。其势稍缓。时作时止。（入门）
痛分诸因
因风痛者。抽掣恶风。因热痛者。烦心恶热。因湿痛者。头重而天阴转甚。因寒痛者。绌急而恶寒战栗。因痰
痛者。昏重而眩晕欲吐。因食痛者。噫酸发热而恶食。气虚痛者。九窍不利。恶劳动。其脉大。血虚痛者。鱼尾
上攻。恶惊惕。其脉芤。肾厥痛者。下虚上实。其脉举之则弦。按之则坚。气逆痛者。心头换痛。其症胸腹胀满。
呕吐酸水。（汇补）
厥头痛症
厥头痛者。所犯大寒。内至骨髓。髓以脑为主。胸中寒邪。故厥逆而头齿皆痛。
真头痛症
真头痛者。引脑及巅。陷入泥丸大痛。手足青冷至节者。旦发夕死。夕发旦死。（用和）外灸百会穴。内进参附
汤。亦有生者。
脉法
寸口紧盛。或短或弦或浮。皆主头痛。又浮弦为风。浮洪为火。细濡为湿。滑大为痰。短涩为虚。
治法
高巅之上。惟风可到。（东垣）古方治头痛。每用风药者。取其味轻。阴中之阳。自地升天者也。在风寒湿者。固
为正用。即虚与热者。亦可假此引经。（必读）
郁热当清
头痛多主于痰。甚必兼火。（丹溪）有久痛而感寒便发。外用重绵包裹者。此属郁热。盖本热而标寒也。因其
本有郁热。毛窍常开。风寒易入。束其内火。闭逆为痛。惟泻火凉血。佐以辛凉散表。（玉纶）
寒湿当取
湿热头痛。心烦重滞。病在隔中。过在手太阳少阴。寒湿头痛。气上而不下。头痛巅疾。下虚上实。过在手少
阴巨阳。甚则入肾。偏头痛者。先取手少阳阳明。后取足少阳阳明。（准绳）
用药
头痛。若属外邪痰火诸有余者。主以二陈汤。风。加羌活、防风。寒。加细辛、 本。湿。加苍术、白芷。火。加
山栀、酒芩。郁热。加酒浸大黄、细辛、芽茶。风热。加天麻、蔓荆。又太阳加 本。阳明加白芷。少阳加柴胡。太阴
加苍术。少阴加细辛。厥阴加吴萸。此六经引经药也。若属气虚者。顺气和中汤。加天麻、川芎。血虚者。四物汤。加
薄荷、甘菊。风热。用清空膏。风痰。用玉壶丸。痰火。用石膏散。寒湿。用芎辛汤。痰厥。用白术半夏天麻汤。肾厥。
用玉真来复丹。肝虚。用生熟地黄丸。肝火。用逍遥散。
快捷方式法
治风虚半边头痛者。用白芷二钱。黄牛脑一个。川芎三钱。入瓷器内。酒煮食之。任量一醉。睡后即愈。 治
寒湿头痛。用白凤仙一株捣烂。火酒浸。露七夕。去渣。饮酒效。 治血气虚而头痛。憎风恶寒。用盐披草纸
上。于痛处以热熨斗熨之。冷即再熨。以平为度。 热郁脑中而痛者。以硝石为末。吹入鼻中。即止。 气郁
偏头痛。用蓖麻同乳香、食盐捣。贴太阳穴。即止。凡外感头目闷痛甚者。用葱叶插入鼻内一二寸。觉气
通。即减。
【附眉棱痛】
眉棱者。目系之所过。上属于脑。外挟风寒。内成郁热。上攻头脑。下注目睛。则眉骨作痛。又有肝火壅热者。
有风痰上攻者。有湿气内郁者。（必读）有肝经血虚。见光则痛者。有肝经伤饮。昼静夜剧身重者。若妇人经
行将尽。不能安养。或以针指劳神。致令眉骨酸痛者。专以益阴养血。（汇补）
【附脑痛】
头脑作痛。犹如刀劈。动辄眩晕。脑后抽掣跳动。举发无时。此肝经痰火。名曰厥疾。厥者。逆也。恚怒太过。气
与血俱逆于高巅。而胆穴又络于脑。宜清痰降火。以芩、连、花粉、胆草、大黄、芦荟、丹皮、赤芍之类。调猪胆汁
服之。若虚弱人患此。宜逍遥散加川芎、生地主之。
用药
肝虚。主以生熟地黄丸。血虚。主以加味逍遥散。湿痰。主以导痰汤。风热。主以上清散。此症失治。多致伤目。
或两耳出脓。则危矣。
头痛选方
二陈汤 统治头痛（方见痰症）
顺气和中汤 治气虚头痛。
即补中益气汤加芍药、川芎、蔓荆、细辛。
加味四物汤 治血虚头痛。
即四物汤加甘菊、蔓荆。
清空膏 治风热头痛。
羌活 防风（各一两） 柴胡（七钱） 川芎（五钱） 甘草（五钱） 黄芩（酒炒三两） 黄连（炒二两）
末之。每服二钱。清茶下。
玉壶丸（和剂） 治风痰头痛。胸膈满。食不下。咳嗽呕吐痰涎。
南星 半夏（各一两） 天麻（半两） 白面（三两）
水滴丸。每服三十丸。姜汤下。
石膏散 治痰火头痛。
川芎（下） 石膏（上） 黄芩（中） 白芷（下）
水煎。
芎辛散 治寒湿头痛。
川芎 细辛（各一钱半） 苍术 甘草 干姜（各一钱）
半夏白术天麻汤 治痰厥头痛。
天麻 白术 半夏（各一钱） 人参 苍术 陈皮 黄 泽泻 茯苓（各五分） 神曲 麦芽（各七分） 干姜
（三分） 黄柏（二分）
水煎。
玉真丸（本事） 治肾厥头痛。
硫黄（二两） 石膏（ ） 半夏 硝石（研各一两）
虚甚者。去石膏。加钟乳粉一两。生姜糊丸。姜汤下。外灸关元百壮。
来复丹（和剂） 治上盛下虚。
硝石（同硫黄研） 玄精石 硫黄（各一两） 五灵脂（水澄去砂） 青皮 陈皮（各二两）
为末。醋糊丸。米饮下。
生熟地黄丸 治肝虚头痛。
生地 熟地（上） 天麻 川芎 茯苓（下） 当归 白芍 黑豆 石斛 玄参 地骨皮（中）
蜜丸。
祛风清上散（统旨） 治风热上攻。
酒芩（二钱） 白芷（一钱半） 防风 柴胡 川芎 荆芥 羌活（各一钱） 甘草（五分）
水煎。
黑锡丹（和剂） 治真头痛。
沉香 附子 葫芦巴 肉桂（各五钱） 茴香 破故纸 金铃子 肉果 木香（各一两） 黑锡 硫黄（炒成珠各
三两）
一方。有阳起石半两。巴戟天一两。酒煮。面糊丸。姜汤下。
羌活黑附汤（东垣） 治寒厥头痛。
麻黄 羌活 防风 苍术（各一钱） 升麻（二分） 甘草（二分） 附子（一分） 白芷（三分）
水煎。
彻清膏
蔓荆 细辛 薄荷 川芎 本 甘草
川芎茶调散（玄珠）
薄荷（三钱） 川芎（一两） 荆芥（四钱） 白芷（五钱） 细芽茶（三钱） 黄芩（二两酒炒）
头顶痛及脑痛。加细辛、 本、蔓荆子各一钱。每服二三钱。清茶下。
【大意】
头部被视为天象（人体上部）。六腑清阳之气，以及五脏精华之血，都汇聚于此。只有当经络之气上逆，侵犯清窍，导致气血无法正常营运时，才会壅滞遏阻而引发疼痛。（出自《微论》）
【内因】
病邪从外部侵入的，是风、寒、暑、湿等邪气；从内部发作的，是气、血、痰、郁等病理变化。（出自《玉机真藏论》）这些邪气要么遮蔽覆盖头部的清明之气，要么瘀塞阻塞经络，与正气相互搏结，导致脉道充盈胀满而产生疼痛。（出自《证治汇补》）
【外候】
头痛牵连两侧额角的，属于太阳经病变；前额头痛牵连眼睛和牙齿的，属于阳明经病变；头角部疼痛牵连耳根的，属于少阳经病变；太阳穴部位疼痛的，属于脾虚；头顶部位疼痛的，属于肾虚；眼球后部连系部位的疼痛，属于肝病变。（出自《证治汇补》）
【痛分内外】
外感引起的头痛，感觉像破碎或撕裂一样，没有休止的时候；内伤引起的头痛，病情相对缓和，时发时止。（出自《医宗必读》）
【痛分诸因】
因风邪引起的头痛，表现为抽搐掣痛、怕风；因热邪引起的头痛，表现为心烦、怕热；因湿邪引起的头痛，表现为头重如裹，且阴天时加重；因寒邪引起的头痛，表现为拘急收缩、怕冷战栗；因痰浊引起的头痛，表现为昏沉沉重、眩晕想吐；因食积引起的头痛，表现为嗳气酸腐、发热、厌恶食物；因气虚引起的头痛，表现为九窍功能不利、厌恶劳累，脉象宏大；因血虚引起的头痛，表现为眼角纹处（鱼尾）向上攻冲、易受惊吓警惕，脉象中空（芤脉）；因肾厥引起的头痛，表现为下虚上实，脉象轻取则弦，重按则坚硬；因气逆引起的头痛，表现为心口部位交替疼痛，症状伴有胸腹胀满、呕吐酸水。（出自《证治汇补》）
【厥头痛症】
所谓厥头痛，是因为遭受了大寒之邪，寒气深入骨髓。髓以脑为主宰，加上胸中有寒邪，所以导致气机厥逆，头部和牙齿都疼痛。
【真头痛症】
所谓真头痛，疼痛牵引至脑部及头顶，陷入泥丸宫（指脑部深处）剧烈疼痛。如果手脚青紫冰冷直到关节，早晨发病晚上死亡，晚上发病早晨死亡。（出自《用和医案》）此时外部艾灸百会穴，内部服用参附汤，也有存活的情况。
【脉法】
寸口脉紧盛，或者短促、弦硬、浮越，都主诉头痛。另外，脉浮弦表示风邪，脉浮洪表示火邪，脉细濡表示湿邪，脉滑大表示痰邪，脉短涩表示虚证。
【治法】
在极高的头顶部位，只有风药才能到达。（出自李东垣）古代方剂治疗头痛，经常使用风药，是取其气味轻清，属于阴中之阳，能从地面升达天空的道理。对于风寒湿邪，这确实是正治之法；即使是虚证和热证，也可以借助这些药物作为引经药。（出自《医宗必读》）
【郁热当清】
头痛大多由痰引起，严重时必然兼夹火邪。（出自朱丹溪）有长期头痛因感受寒邪而发作，外部用厚棉包裹保暖的，这属于郁热。因为本质是热而表象是寒。由于体内本有郁热，毛孔常开，风寒容易进入，束缚住体内的火气，闭塞逆乱而导致疼痛。治疗应当泻火凉血，佐以辛凉发散表邪。（出自《张氏医通》）
【寒湿当取】
湿热头痛，伴有心烦、身体沉重滞涩，病位在膈中，经过手太阳小肠经和手少阴心经。寒湿头痛，气机上逆而不能下行，导致头痛巅疾，下虚上实，经过手少阴心经和足太阳膀胱经，严重时会传入肾脏。偏头痛者，先取手少阳三焦经和手阳明大肠经的穴位，后取足少阳胆经和足阳明胃经的穴位。（出自《医学准绳六要》）
【用药】
头痛，如果属于外邪、痰、火等实证有余的，主要使用二陈汤。风邪，加羌活、防风；寒邪，加细辛、藁本；湿邪，加苍术、白芷；火邪，加山栀、酒炒黄芩；郁热，加酒浸大黄、细辛、芽茶；风热，加天麻、蔓荆子。此外，太阳经头痛加藁本，阳明经头痛加白芷，少阳经头痛加柴胡，太阴经头痛加苍术，少阴经头痛加细辛，厥阴经头痛加吴茱萸。这是六经的引经药。如果属于气虚的，使用顺气和中汤，加天麻、川芎。血虚的，使用四物汤，加薄荷、甘菊。风热头痛，使用清空膏。风痰头痛，使用玉壶丸。痰火头痛，使用石膏散。寒湿头痛，使用芎辛汤。痰厥头痛，使用半夏白术天麻汤。肾厥头痛，使用玉真来复丹。肝虚头痛，使用生熟地黄丸。肝火头痛，使用逍遥散。
【快捷方式法】
治疗风虚引起的半边头痛，用白芷二钱，黄牛脑一个，川芎三钱，放入瓷器内，用酒煮后食用，适量饮酒至醉，睡醒后即刻痊愈。治疗寒湿头痛，用白凤仙花一株捣烂，用烧酒浸泡，露置七夕之夜，去渣后饮酒有效。治疗气血虚而头痛，憎风恶寒，用盐拌草纸，在疼痛处用热熨斗熨烫，冷了再熨，直到平复为止。热郁于脑中而痛，将硝石研末，吹入鼻中，疼痛即止。气郁引起的偏头痛，用蓖麻同乳香、食盐捣烂，贴敷在太阳穴，疼痛即止。凡是外感引起的头目闷痛严重的，用葱叶插入鼻内一二寸，感觉到气通畅，疼痛就会减轻。
【附眉棱痛】
眉棱骨，是目系经过的地方，向上连接脑部，外部挟带风寒，内部形成郁热，向上攻冲头脑，向下注视眼珠，就会导致眉骨疼痛。又有肝火壅热的，有风痰上攻的，有湿气内郁的。（出自《医宗必读》）有肝经血虚，见光就痛的，有肝经伤饮，白天安静夜晚加剧且身体沉重的。如果是妇女月经行将结束，不能安养，或者因针线劳作劳神，导致眉骨酸痛，专门采用益阴养血的方法。（出自《证治汇补》）
【附脑痛】
头脑作痛，犹如刀劈一般，动不动就眩晕，脑后抽掣跳动，随时都可能发作。这是肝经痰火，名叫厥疾。厥，就是逆乱的意思。恚怒太过，气与血一起逆乱于高巅之上，而胆穴又络属于脑，应当清化痰浊、降泄火邪，使用黄芩、黄连、花粉、龙胆草、大黄、芦荟、丹皮、赤芍之类，调猪胆汁送服。如果是虚弱的人患此病，宜用逍遥散加川芎、生地主治。
【用药】
肝虚，主要使用生熟地黄丸。血虚，主要使用加味逍遥散。湿痰，主要使用导痰汤。风热，主要使用上清散。此症如果失治，多会导致伤目，或者两耳流脓，那就危险了。
【头痛选方】
二陈汤：统治各种头痛（方剂见痰症章节）
顺气和中汤：治疗气虚头痛。
即补中益气汤加芍药、川芎、蔓荆子、细辛。
加味四物汤：治疗血虚头痛。
即四物汤加甘菊、蔓荆子。
清空膏：治疗风热头痛。
羌活、防风（各一两），柴胡（七钱），川芎（五钱），甘草（五钱），黄芩（酒炒三两），黄连（炒二两）。
研为末。每次服用二钱，清茶送下。
玉壶丸（出自《太平惠民和剂局方》）：治疗风痰头痛，胸膈满闷，饮食不下，咳嗽呕吐痰涎。
南星、半夏（各一两），天麻（半两），白面（三两）。
滴水泛丸。每次服用三十丸，姜汤送下。
石膏散：治疗痰火头痛。
川芎（下部），石膏（上部），黄芩（中部），白芷（下部）。
水煎服。
芎辛散：治疗寒湿头痛。
川芎、细辛（各一钱半），苍术、甘草、干姜（各一钱）。
半夏白术天麻汤：治疗痰厥头痛。
天麻、白术、半夏（各一钱），人参、苍术、陈皮、黄芪、泽泻、茯苓（各五分），神曲、麦芽（各七分），干姜（三分），黄柏（二分）。
水煎服。
玉真丸（出自《本事方》）：治疗肾厥头痛。
硫黄（二两），石膏（缺量，通常视情况加减），半夏、硝石（研细各一两）。
虚损严重者，去掉石膏，加钟乳粉一两。生姜糊丸，姜汤送下。外部艾灸关元穴一百壮。
来复丹（出自《太平惠民和剂局方》）：治疗上盛下虚。
硝石（同硫黄一起研细），玄精石、硫黄（各一两），五灵脂（水飞澄去砂），青皮、陈皮（各二两）。
研为末，醋糊丸，米饮送下。
生熟地黄丸：治疗肝虚头痛。
生地、熟地（上部药），天麻、川芎、茯苓（下部药），当归、白芍、黑豆、石斛、玄参、地骨皮（中部药）。
蜜丸。
祛风清上散（出自《统旨方》）：治疗风热上攻。
酒炒黄芩（二钱），白芷（一钱半），防风、柴胡、川芎、荆芥、羌活（各一钱），甘草（五分）。
水煎服。
黑锡丹（出自《太平惠民和剂局方》）：治疗真头痛。
沉香、附子、葫芦巴、肉桂（各五钱），茴香、破故纸、金铃子、肉果、木香（各一两），黑锡、硫黄（炒成珠各三两）。
另一方，有阳起石半两，巴戟天一两。酒煮，面糊丸，姜汤送下。
羌活黑附汤（出自李东垣）：治疗寒厥头痛。
麻黄、羌活、防风、苍术（各一钱），升麻（二分），甘草（二分），附子（一分），白芷（三分）。
水煎服。
彻清膏
蔓荆子、细辛、薄荷、川芎、藁本、甘草
川芎茶调散（出自《玄珠》）
薄荷（三钱），川芎（一两），荆芥（四钱），白芷（五钱），细芽茶（三钱），黄芩（二两酒炒）。
头顶痛及脑痛，加细辛、藁本、蔓荆子各一钱。每次服用二三钱，清茶送下。
[General Principle]
The head is regarded as the celestial aspect (the upper part of the human body). The clear yang qi of the six fu organs, and the essence blood of the five zang organs, all converge here. Only when the qi of the meridians rebels upward, invading the clear orifices, causing the qi and blood to fail in normal circulation, will stagnation and obstruction occur, leading to pain. (From *Wei Lun*)
[Etiology: Internal Factors]
Pathogenic factors entering from the exterior are wind, cold, summer-heat, and dampness; those arising from within are abnormalities of qi, blood, phlegm, and depression. (From *Yu Ji Zhen Cang Lun*) These pathogenic factors either obscure and cover the clarity of the head, or obstruct and block the meridians, contending with healthy qi, resulting in fullness and distension of the vessels and pain. (From *Zheng Zhi Hui Bu*)
[External Manifestations]
Headache radiating to both foreheads belongs to the Taiyang channel. Headache involving the forehead, eyes, and teeth belongs to the Yangming channel. Headache at the temples radiating to the root of the ears belongs to the Shaoyang channel. Pain at the temporal region belongs to Spleen deficiency. Pain at the vertex belongs to Kidney deficiency. Pain in the ocular system belongs to Liver pathology. (From *Zheng Zhi Hui Bu*)
[Differentiation: External vs. Internal]
Headache due to external contraction feels like breaking or tearing, without cessation. Headache due to internal injury is relatively milder in intensity, occurring intermittently. (From *Yi Zong Bi Du*)
[Differentiation by Etiology]
Headache due to wind presents with twitching, pulling pain, and aversion to wind. Headache due to heat presents with vexation and aversion to heat. Headache due to dampness presents with heaviness in the head, worsening on cloudy days. Headache due to cold presents with contraction, tightness, aversion to cold, and shivering. Headache due to phlegm presents with dizziness, heaviness, and a desire to vomit. Headache due to food retention presents with sour belching, fever, and anorexia. Headache due to qi deficiency presents with dysfunction of the nine orifices, aversion to exertion, and a large pulse. Headache due to blood deficiency presents with pain attacking upwards from the outer canthus (fish tail), fearfulness, and a knifelike (Kou) pulse. Headache due to Jue (rebellious) Kidney presents with deficiency below and excess above, with a pulse that is wiry on light palpation and firm on deep palpation. Headache due to qi rebellion presents with alternating pain in the heart region, accompanied by chest and abdominal fullness, and vomiting of sour fluid. (From *Zheng Zhi Hui Bu*)
[Jue Tou Tong Syndrome]
"Jue Tou Tong" (Rebellious Headache) occurs due to severe cold invasion penetrating to the bone marrow. Since marrow governs the brain, combined with cold evil in the chest, it causes rebellious qi flow, resulting in pain in both the head and teeth.
[Zhen Tou Tong Syndrome]
"Zhen Tou Tong" (True Headache) involves pain radiating to the brain and vertex, sinking into the "Ni Wan" (deep brain) with severe pain. If the hands and feet turn blue and cold up to the joints, death occurs on the same day (morning onset leads to evening death; evening onset leads to morning death). (From *Yong He Yi An*) In such cases, external moxibustion at Baihui (GV20) and internal administration of Shen Fu Tang (Ginseng and Aconite Decoction) may result in survival.
[Pulse Diagnosis]
A tight, excessive, short, wiry, or floating pulse at the Cun Kou (radial artery) indicates headache. Specifically, a floating-wiry pulse indicates wind; floating-hong indicates fire; fine-and-soggy indicates dampness; slippery-and-large indicates phlegm; short-and-choppy indicates deficiency.
[Therapeutic Principles]
At the highest point of the head, only wind herbs can reach. (From Li Dongyuan) Ancient formulas for treating headache often use wind herbs because their flavors are light, representing "yang within yin," rising from earth to heaven. For wind-cold-dampness, this is the direct treatment; even for deficiency and heat patterns, these herbs can be used as guiding agents. (From *Yi Zong Bi Du*)
[Clearing Depressed Heat]
Headache is mostly governed by phlegm, and in severe cases, accompanied by fire. (From Zhu Danxi) Some long-term headaches triggered by cold exposure, treated externally with thick cotton wrapping, belong to depressed heat. The root is heat, but the branch is cold. Because there is inherent depressed heat, the pores are often open, allowing wind-cold to enter easily, binding the internal fire and causing obstruction and rebellion, leading to pain. Treatment should involve purging fire and cooling blood, assisted by acrid-cool herbs to dissipate the exterior. (From *Zhang Shi Yi Tong*)
[Addressing Cold-Dampness]
Damp-heat headache presents with vexation and heavy stagnation, located in the diaphragm, passing through the Hand Taiyang Small Intestine and Hand Shaoyin Heart channels. Cold-damp headache involves qi rebelling upward without descending, causing headache and vertigo, with deficiency below and excess above, passing through the Hand Shaoyin Heart and Foot Taiyang Bladder channels, potentially entering the Kidneys. For migraines, first select points from the Hand Shaoyang Sanjiao and Hand Yangming Large Intestine channels, then select points from the Foot Shaoyang Gallbladder and Foot Yangming Stomach channels. (From *Yi Xue Zhun Sheng Liu Yao*)
[Medication]
For headache caused by external pathogens, phlegm, or fire (excess patterns), Er Chen Tang (Two-Cured Decoction) is the primary formula. For wind, add Qiang Huo (Notopterygii Rhizoma et Radix) and Fang Feng (Saposhnikoviae Radix); for cold, add Xi Xin (Asari Radix) and Gao Ben (Ligustici Chuanxiong Rhizoma); for dampness, add Cang Zhu (Atractylodis Rhizoma) and Bai Zhi (Angelicae Dahuricae Radix); for fire, add Shan Zhi (Gardeniae Fructus) and Jiu Qin (Scutellariae Radix fried with wine); for depressed heat, add Jiu Da Huang (Rhei Radix et Rhizoma soaked in wine), Xi Xin, and Ya Cha (Sprouted Tea); for wind-heat, add Tian Ma (Gastrodiae Rhizoma) and Man Jing Zi (Viticis Semen). Additionally, Taiyang headaches add Gao Ben; Yangming headaches add Bai Zhi; Shaoyang headaches add Chai Hu (Bupleuri Radix); Taiyin headaches add Cang Zhu; Shaoyin headaches add Xi Xin; Jueyin headaches add Wu Yu (Evodiae Fructus). These are the guiding herbs for the Six Channels. For qi deficiency, Shun Qi He Zhong Tang (Regulating Qi and Harmonizing Middle Decoction) is used, adding Tian Ma and Chuan Xiong (Chuanxiong Rhizoma). For blood deficiency, Si Wu Tang (Four Substances Decoction) is used, adding Bo He (Menthae Haplocalycis Herba) and Gan Ju (Chrysanthemi Flos). For wind-heat headache, Qing Kong Gao (Clearing Empty Paste) is used. For wind-phlegm headache, Yu Hu Wan (Jade Pot Pill) is used. For phlegm-fire headache, Shi Gao San (Gypsum Powder) is used. For cold-damp headache, Xiong Xin San (Ligusticum and Asari Powder) is used. For phlegm-Jue headache, Ban Xia Bai Zhu Tian Ma Tang (Pinellia, Atractylodes Macrocephala, and Gastrodia Decoction) is used. For Kidney-Jue headache, Yu Zhen Lai Fu Dan (Jade True Returning Pellet) is used. For Liver deficiency headache, Sheng Shu Di Huang Wan (Raw and Prepared Rehmannia Pill) is used. For Liver fire headache, Xiao Yao San (Free and Easy Wanderer Powder) is used.
[Rapid Methods]
To treat half-headache due to wind-deficiency, use 2 qian of Bai Zhi, one yellow ox brain, and 3 qian of Chuan Xiong. Place in a porcelain vessel, boil in wine, and consume. Drink until intoxicated; upon waking, the pain will cease. To treat cold-damp headache, take one plant of Bai Feng Xian (Impatiens balsamina), mash it, soak in liquor, expose to dew on the seventh day of the seventh lunar month, strain, and drink the liquid. To treat headache due to qi-blood deficiency with aversion to wind and cold, sprinkle salt on grass paper, apply a hot iron to the painful area, reapply when cool, until resolved. For heat depression in the brain causing pain, blow powdered Xiao Shi (Niter) into the nose to stop pain immediately. For qi-depression migraines, mash Bi Ma (Ricini Semen) with Ru Xiang (Olibanum) and salt, and apply to the Taiyang acupoint to stop pain. For severe stuffy pain in the head and eyes due to external contraction, insert scallion leaves 1-2 cun into the nose; once qi flow is felt, pain decreases.
[Appendix: Meiling Pain]
Meiling (supraorbital ridge) is where the ocular system passes, connecting upward to the brain. Externally affected by wind-cold and internally forming depressed heat, it attacks upward to the head and downward to the eyes, causing pain in the brow bone. Other causes include Liver fire congestion, wind-phlegm attacking upward, and internal dampness depression. (From *Yi Zong Bi Du*) There are cases of Liver channel blood deficiency causing pain upon exposure to light, and Liver channel injury from fluids causing quietness by day and aggravation with heaviness by night. In women nearing the end of menstruation, if nourishment is insufficient, or due to mental labor from needlework, causing sore ache in the brow bone, the treatment focuses specifically on nourishing yin and blood. (From *Zheng Zhi Hui Bu*)
[Appendix: Naotong (Brain Pain)]
Head pain resembling a chop, accompanied by frequent dizziness, twitching and throbbing at the back of the head, occurring at any time. This is Liver channel phlegm-fire, named Jue Ji (Rebellious Disease). "Jue" means rebellion. Excessive anger causes qi and blood to rebel together to the highest peak, and since the Gallbladder channel connects to the brain, treatment should clear phlegm and descend fire using Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Hua Fen (Trichosanthis Radix), Dan Cao (Gentianae Radix), Da Huang (Rhei Radix et Rhizoma), Lu Hui (Aloe), Mu Dan Pi (Moutan Cortex), and Chi Shao (Paeoniae Radix Rubra), mixed with pig bile for administration. For weak individuals suffering from this, Xiao Yao San plus Chuan Xiong and Sheng Di Huang (Rehmanniae Radix) should be used.
[Medication]
For Liver deficiency, primarily use Sheng Shu Di Huang Wan. For blood deficiency, primarily use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder). For damp-phlegm, primarily use Dao Tan Tang (Guiding Phlegm Decoction). For wind-heat, primarily use Shang Qing San (Upper Clearing Powder). If this condition is neglected, it often damages the eyes or causes pus discharge from both ears, which is critical.
[Selected Formulas for Headache]
Er Chen Tang: Universally treats headache (Formula see Phlegm Syndrome section).
Shun Qi He Zhong Tang: Treats qi-deficiency headache.
It is Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) added with Shao Yao (Paeoniae Radix), Chuan Xiong, Man Jing Zi, and Xi Xin.
Jia Wei Si Wu Tang: Treats blood-deficiency headache.
It is Si Wu Tang added with Gan Ju (Chrysanthemi Indici Flos) and Man Jing Zi.
Qing Kong Gao: Treats wind-heat headache.
Qiang Huo, Fang Feng (each 1 liang), Chai Hu (7 qian), Chuan Xiong (5 qian), Gan Cao (Licorice Root, 5 qian), Huang Qin (3 liang fried with wine), Huang Lian (2 liang stir-fried).
Grind into powder. Take 2 qian each time, washed down with clear tea.
Yu Hu Wan (from *He Ji Ju Fang*): Treats wind-phlegm headache, chest and diaphragm fullness, inability to eat, cough, and vomiting of phlegm-saliva.
Tian Nan Xing (Arisaematis Rhizoma), Ban Xia (Pinelliae Rhizoma) (each 1 liang), Tian Ma (0.5 liang), Bai Mian (Wheat Flour, 3 liang).
Make pills with water drops. Take 30 pills each time, washed down with ginger soup.
Shi Gao San: Treats phlegm-fire headache.
Chuan Xiong (lower layer), Shi Gao (Gypsum, upper layer), Huang Qin (middle layer), Bai Zhi (lower layer).
Decoct in water.
Xiong Xin San: Treats cold-damp headache.
Chuan Xiong, Xi Xin (each 1.5 qian), Cang Zhu, Gan Cao, Gan Jiang (Dried Ginger) (each 1 qian).
Ban Xia Bai Zhu Tian Ma Tang: Treats phlegm-Jue headache.
Tian Ma, Bai Zhu, Ban Xia (each 1 qian), Ren Shen (Ginseng Radix et Rhizoma), Cang Zhu, Chen Pi (Citri Reticulatae Pericarpium), Huang Qi (Astragali Radix), Ze Xie (Alismatis Rhizoma), Fu Ling (Poria) (each 0.5 qian), Shen Qu (Massa Medicata Fermentata), Mai Ya (Hordei Fructus Germinatus) (each 0.7 qian), Gan Jiang (0.3 qian), Huang Bo (Phellodendri Cortex) (0.2 qian).
Decoct in water.
Yu Zhen Wan (from *Ben Shi Fang*): Treats Kidney-Jue headache.
Liu Huang (Sulfur, 2 liang), Shi Gao, Ban Xia, Xiao Shi (Natrii Sulfas) (ground, each 1 liang).
For severe deficiency, remove Shi Gao and add Zhong Ru Fen (Stalactitum Powder, 1 liang). Make pills with ginger paste, washed down with ginger soup. External moxibustion at Guan Yuan (CV4) for 100 moxa cones.
Lai Fu Dan (from *He Ji Ju Fang*): Treats excess above and deficiency below.
Xiao Shi (ground with Liu Huang), Xuan Jing Shi (Mirabilite), Liu Huang (each 1 liang), Wu Ling Zhi (Trogopterori Faeces) (water-cleaned to remove sand), Qing Pi (Citri Reticulatae Pericarpium Viride), Chen Pi (each 2 liang).
Grind into powder, make pills with vinegar paste, washed down with rice drink.
Sheng Shu Di Huang Wan: Treats Liver-deficiency headache.
Sheng Di Huang (Prepared Rehmannia Root), Shu Di Huang (upper layer), Tian Ma, Chuan Xiong, Fu Ling (lower layer), Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), Hei Dou (Black Soybean), Shi Hu (Dendrobii Caulis), Xuan Shen (Scrophulariae Radix), Di Gu Pi (Lycii Cortex) (middle layer).
Make pills with honey.
Qu Feng Qing Shang San (from *Tong Zhi Fang*): Treats wind-heat attacking upward.
Jiu Qin (2 qian), Bai Zhi (1.5 qian), Fang Feng, Chai Hu, Chuan Xiong, Jing Jie (Schizonepetae Spica), Qiang Huo (each 1 qian), Gan Cao (0.5 qian).
Decoct in water.
Hei Xi Dan (from *He Ji Ju Fang*): Treats True Headache.
Chen Xiang (Aquilariae Lignum Resinatum), Fu Zi (Aconiti Lateralis Radix Praeparata), Hu Lu Ba (Trigonellae Semen), Rou Gui (Cinnamomi Cortex) (each 5 qian), Hui Xiang (Foeniculi Fructus), Po Gu Zhi (Psoraleae Fructus), Jin Ling Zi (Meliae Fructus), Rou Guo (Myristicae Semen), Mu Xiang (Aucklandiae Radix) (each 1 liang), Hei Xi (Lead), Liu Huang (fried into beads, each 3 liang).
Another prescription includes Yang Qi Shi (Pyritum, 0.5 liang) and Ba Ji Tian (Morindae Officinalis Radix, 1 liang). Decoct in wine, make pills with wheat paste, washed down with ginger soup.
Qiang Huo Hei Fu Tang (from Li Dongyuan): Treats cold-Jue headache.
Ma Huang (Ephedrae Herba), Qiang Huo, Fang Feng, Cang Zhu (each 1 qian), Sheng Ma (Cimicifugae Rhizoma, 2 fen), Gan Cao (2 fen), Fu Zi (1 fen), Bai Zhi (3 fen).
Decoct in water.
Che Qing Gao
Man Jing Zi, Xi Xin, Bo He (Menthae Haplocalycis Herba), Chuan Xiong, Gao Ben, Gan Cao
Chuan Xiong Cha Tiao San (from *Xuan Zhu*)
Bo He (3 qian), Chuan Xiong (1 liang), Jing Jie (4 qian), Bai Zhi (5 qian), Xi Ya Cha (Fine Sprouted Tea, 3 qian), Huang Qin (2 liang fried with wine).
For vertex headache and brain pain, add Xi Xin, Gao Ben, and Man Jing Zi (each 1 qian). Take 2-3 qian each time, washed down with clear tea.