大意
头风。即首风也。新浴中风。即为首风。（内经）头风与头痛无异。浅而近者名头痛。深而远者名头风。（绳墨）
内因
因风寒入于脑髓也。盖头为诸阳之会。必其人素有痰火。或栉沐取凉。或醉饱仰卧。贼风入脑。致令郁热
闷痛。妇人多患此者。因无巾帻以遇风寒也。（入门）
外候
其状头汗恶风。当先一日则病甚。头痛不可以出内。至其风日则病稍愈。（内经）有头皮浮顽不自觉者。有
口舌不知味者。或耳鸣。或目痛。或眉棱之间。有一处不若吾体。皆其渐也。（入门）
头风偏正
正头风者。满头皆痛。甚则项强。身体拘急。常兼左右。偏头风但在半边。在左多血虚有火。或风热。在右多
气虚痰郁。或风湿。（汇补）
头风分辨
血虚者。朝轻夕重。气虚者。朝重夕轻。风热痛者。遇热则发。风湿痛者。阴雨则甚。湿痰痛者。绵密无间。眩晕
吐逆。火郁痛者。喜暖畏光。面赤口渴。（汇补）
头风瞎眼
木生于春。病在肝。目者肝之窍。肝风动则邪害孔窍也。故有年久头风。便燥目赤眩晕者。乃肺金乘肝。气
郁血壅而然。宜清上彻下之法。（入门）世人不知此理。专行苦寒。使火无发越。上攻于目。或专行辛散。使血
耗火炎。上瘀于目。宜乎头风之必害眼也。（汇补）
治法
宜凉血泻火为主。佐以辛温散表从治。外感发者。散风而邪自去。内伤发者。养血而风自除。（汇补）
用药
痰主二陈汤。加苍术、南星。热。加酒芩、连、栀。血主四物。倍川芎、荆芥。风。加防风、甘菊。欲辛散。少加
细辛、薄荷。以开上焦火郁。欲清彻。少加酒大黄。以清上利下。
【附雷头风】
内郁痰火。外束风热。故头痛而起核。或脑响如雷鸣。宜清震汤主之。盖雷者震也。震仰盂。用青荷叶者。象
震之形与色也。势重者。先用探吐攻下之法。次用清痰降火之剂。（汇补）
【附大头风】
冒天地不正之气。邪伏经络。上攻清道。故头大如斗。甚则溃裂出脓。治以消毒饮。更视三阳经部分而分
治之。俟大便结。然后议下。此先缓后急之法也。设或便未结而遽行之。未有不暗伤元气。邪走内地。而变
端百出矣。（汇补）
头风选方
二陈汤 治头风湿痰有余之症。（方见痰症）
四物汤 治头风血虚不足之症。（方见中风）
透顶散 治头风脑寒。
细辛（三茎） 瓜蒂（七枚） 丁香（三粒） 糯米（七粒） 脑子 麝（各豆大一粒）
为末。随左右头风搐鼻内。良久。出涎升许。即愈。
川芎散 治头风郁热。
青黛（二钱五分） 蔓荆 川芎（各一钱二分） 郁金 芒硝（各一钱） 石膏（一钱三分） 细辛根（七分） 薄
荷（二钱） 红豆（一粒）
上为末。搐病患鼻内。
快捷方式法 偏正头风。用蓖麻子五钱。去壳。大枣十五枚。共打研如泥。用箸卷之。去箸纳鼻中。良久取下。清
浊涕即止。此治痰涎邪气郁于头而成病者。如火郁而成者。用莱菔汁。仰卧注鼻中。左痛注右。右痛
注左。又方。用白芥子五钱。蓖麻子五粒。川芎、白芷末各一钱。同捣成膏。贴患处。其痛即减。
清震方（保命） 治雷头风病。
升麻 苍术（各四两） 荷叶（一片）
水煎。
新制方 治雷头风病。能清上导下。
半夏（一两） 大黄（二两） 天麻 黄芩（各六钱） 薄荷（三钱） 甘草（三钱）
水泛丸。临卧。清茶吞二钱。以痰利为度。
消毒饮（东垣） 治大头风病。
黄芩 黄连（各半两） 人参 橘红 玄参 甘草（各二钱） 连翘 大力子 桔梗 板蓝根 马屁勃（各一钱） 白
僵蚕 升麻 防风 薄荷 当归（各二钱）
便闭。加大黄一钱微利之。
【大意】
头风，就是首风。刚洗完澡就受风，就会形成首风。《黄帝内经》认为头风与头痛没有区别。病位浅且病程短的称为头痛；病位深且病程久的称为头风。（出自《医宗绳墨》）
【内因】
由于风寒侵入脑髓所致。因为头部是诸阳经汇聚的地方，所以患者通常素有痰火之邪，或者在洗头沐浴时受凉，或者在醉酒后饱食仰卧，导致贼风侵入脑部，致使郁热闷痛。妇女多患此病，是因为她们不戴头巾帽子来抵御风寒。（出自《医学入门》）
【外候】
症状表现为头部出汗、怕风。通常在发病前一天病情加重，头痛剧烈到不敢进出房间，到了有风的天气病情反而稍有好转。（出自《黄帝内经》）有的患者头皮麻木迟钝而不自知，有的口舌失去味觉，或者耳鸣，或者眼睛疼痛，或者眉棱骨处感觉异常，不如身体其他部位舒适，这些都是逐渐发展的征兆。（出自《医学入门》）
【头风偏正】
正头风，是整个头部都痛，严重时颈部僵硬，身体拘挛紧急，常常左右两侧同时发作。偏头风只发生在半边头部，左侧的多为血虚有火，或风热所致；右侧的多为气虚痰郁，或风湿所致。（出自《证治汇补》）
【头风分辨】
血虚引起的头痛，早晨轻晚上重；气虚引起的头痛，早晨重晚上轻。风热引起的疼痛，遇热则发作；风湿引起的疼痛，阴雨天气则加重；湿痰引起的疼痛，连绵不断无休止，伴有眩晕呕吐；火郁引起的疼痛，喜欢温暖但畏惧光线，面色红赤口渴。（出自《证治汇补》）
【头风瞎眼】
木气生于春季，病变在肝。眼睛是肝的窍道，肝风内动则邪气侵害孔窍。所以有多年久治不愈的头风，伴有大便干燥、眼睛红赤眩晕的，这是肺金克制肝木，气机郁滞、血液壅塞所致。适宜采用清上彻下的治疗方法。（出自《医学入门》）世人不懂这个道理，专门使用苦寒药物，使火热之气无法发散，反而上攻于目；或者专门使用辛散药物，使血液耗损、火势炎上，瘀血阻滞于目。因此头风必然会导致眼疾。（出自《证治汇补》）
【治法】
应当以凉血泻火为主，佐以辛温药物发散表邪，顺从病势治疗。由外感引发的，疏散风邪则邪气自去；由内伤引发的，养血则风邪自除。（出自《证治汇补》）
【用药】
若是痰证，主用二陈汤，加苍术、天南星。若是热证，加酒炒黄芩、黄连、栀子。若是血证，主用四物汤，加倍使用川芎、荆芥。若是风证，加防风、甘菊花。想要辛散，少量加入细辛、薄荷，以开通上焦的火郁。想要清上彻下，少量加入酒大黄，以清上利下。
【附雷头风】
内里郁结痰火，外部束缚风热，所以头痛且起核块，或者头脑响声如雷鸣。宜用清震汤主治。所谓“雷”即“震”，震卦象为仰盂，所以使用青荷叶，是象征震卦的形状和颜色。病情严重的，先用探吐攻下的方法，随后使用清痰降火的药剂。（出自《证治汇补》）
【附大头风】
冒犯天地不正之气，邪气潜伏在经络中，向上攻冲清窍，所以头部肿大如斗，严重时溃烂流脓。治疗用消毒饮，再根据三阳经的部位分别治疗。等到大便干结后，然后考虑使用攻下法。这是先缓后急的方法。假如大便未干结却急于攻下，无不暗中损伤元气，导致邪气深入体内，从而变端百出。（出自《证治汇补》）
【头风选方】
二陈汤：治疗头风湿痰有余的病症。（方剂见痰症章节）
四物汤：治疗头风血虚不足的病症。（方剂见中风章节）
透顶散：治疗头风脑寒。
组成：细辛（三茎）、瓜蒂（七枚）、丁香（三粒）、糯米（七粒）、脑子、麝香（各豆大一粒）。
研为末，根据头痛在左或右，搐鼻吸入。良久，吐出涎沫一升左右，即可痊愈。
川芎散：治疗头风郁热。
组成：青黛（二钱五分）、蔓荆子、川芎（各一钱二分）、郁金、芒硝（各一钱）、石膏（一钱三分）、细辛根（七分）、薄荷（二钱）、红豆（一粒）。
以上研为末，搐入患者鼻内。
快捷方式法：治疗偏正头风，用蓖麻子五钱，去壳，大枣十五枚，共同捣研如泥状。用筷子卷成条状，去掉筷子纳入鼻中。良久取下，清浊鼻涕即止。这是治疗痰涎邪气郁结于头部而成病的。如果是火郁而成的，用莱菔汁，仰卧注入鼻中，左痛注右鼻孔，右痛注左鼻孔。又一方：用白芥子五钱，蓖麻子五粒，川芎、白芷末各一钱，同捣成膏，贴敷患处，疼痛即减轻。
清震方（出自《脾胃论·保命集》）：治疗雷头风病。
组成：升麻、苍术（各四两）、荷叶（一片）。
水煎服。
新制方：治疗雷头风病，能清上导下。
组成：半夏（一两）、大黄（二两）、天麻、黄芩（各六钱）、薄荷（三钱）、甘草（三钱）。
用水泛丸。临睡前，用清茶吞服二钱，以痰利为度。
消毒饮（出自李东垣）：治疗大头风病。
组成：黄芩、黄连（各半两）、人参、橘红、玄参、甘草（各二钱）、连翘、牛蒡子、桔梗、板蓝根、马屁勃（各一钱）、白僵蚕、升麻、防风、薄荷、当归（各二钱）。
若大便闭结，加大黄一钱，轻微通利即可。
[General Principle]
Toufeng (Head Wind), also known as Shoufeng (First Wind). Contracting wind immediately after bathing results in Shoufeng. According to the *Huangdi Neijing* (Yellow Emperor's Inner Canon), Toufeng and Toubi (Headache) are essentially the same. When the pathology is superficial and recent, it is called Toubi; when it is deep-seated and chronic, it is called Toufeng. (From *Yizong Shengmo*)
[Etiology - Internal Factors]
It is caused by Wind-Cold invading the brain marrow. The head is the confluence of all Yang meridians. Therefore, patients usually have pre-existing Phlegm-Fire, or they catch cold while washing hair and bathing, or lie supine after drinking and overeating. This allows "Thief Wind" to enter the brain, causing stagnant heat and stifling pain. Women suffer from this condition frequently because they do not wear headscarves or hats to ward off Wind-Cold. (From *Yixue Rumen*)
[External Manifestations]
Symptoms include sweating on the head and aversion to wind. The condition typically worsens one day prior to onset, with severe headache preventing the patient from entering or leaving rooms. It improves slightly on windy days. (From *Huangdi Neijing*) Some patients experience numbness and insensitivity of the scalp without realizing it; others lose taste sensation in the mouth and tongue, suffer from tinnitus, eye pain, or abnormal sensations in the glabella region that differ from the rest of the body. These are gradual developments. (From *Yixue Rumen*)
[Pian Zheng Toufeng - Lateral vs. Central Head Wind]
Zheng Toufeng (Central Head Wind) involves pain throughout the entire head, sometimes accompanied by neck stiffness and bodily rigidity, often affecting both left and right sides simultaneously. Pian Toufeng (Lateral Head Wind) affects only one side of the head. Left-sided cases are mostly due to Blood deficiency with Fire, or Wind-Heat. Right-sided cases are mostly due to Qi deficiency with Phlegm stagnation, or Wind-Dampness. (From *Zhengzhi Huibu*)
[Differentiation of Toufeng]
Pain due to Blood deficiency is lighter in the morning and heavier in the evening. Pain due to Qi deficiency is heavier in the morning and lighter in the evening. Pain due to Wind-Heat occurs upon exposure to heat. Pain due to Wind-Dampness worsens during rainy weather. Pain due to Damp-Phlegm is continuous and unceasing, accompanied by vertigo and vomiting. Pain due to Stagnant Fire prefers warmth but fears light, presenting with a red face and thirst. (From *Zhengzhi Huibu*)
[Toufeng Leading to Blindness]
Wood energy arises in Spring, and pathology resides in the Liver. The eyes are the orifices of the Liver. When Liver Wind moves internally, pathogens harm the orifices. Thus, chronic Toufeng lasting for years, accompanied by dry stool, red eyes, and vertigo, is caused by Lung Metal overcoming Liver Wood, leading to Qi stagnation and Blood congestion. The appropriate treatment is a method that clears the upper and drains the lower. (From *Yixue Rumen*) People who do not understand this principle use exclusively bitter-cold herbs, preventing the Fire from dispersing, causing it to attack the eyes upward; or they use exclusively acrid-dispersing herbs, depleting the Blood and allowing Fire to flare up, causing blood stasis to obstruct the eyes. Hence, Toufeng inevitably harms the eyes. (From *Zhengzhi Huibu*)
[Therapeutic Principles]
Treatment should primarily focus on cooling Blood and purging Fire, assisted by acrid-warm herbs to disperse exterior pathogens and treat according to the disease's nature. If triggered by external contraction, dispersing Wind causes the pathogen to leave; if triggered by internal injury, nourishing Blood eliminates the Wind. (From *Zhengzhi Huibu*)
[Prescription Usage]
For Phlegm syndromes, use Erchen Tang (Two-Aged Decoction) with added Cangzhu (Atractylodis Rhizoma) and Nanting (Arisaematis Rhizoma Preparatum). For Heat syndromes, add Jiuhuangqin (Scutellariae Radix prepared with wine), Lian (Coptidis Rhizoma), and Zhi (Gardeniae Fructus). For Blood syndromes, use Siwu Tang (Four Substances Decoction), doubling the dosage of Chuanxiong (Chuanxiong Rhizoma) and Jingjie (Schizonepetae Herba). For Wind syndromes, add Fangfeng (Saposhnikoviae Radix) and Ganju (Chrysanthemi Flos). To promote acrid dispersion, add small amounts of Xixin (Asari Radix et Rhizoma) and Bohe (Menthae Haplocalycis Herba) to open stagnant Fire in the Upper Jiao. To clear the upper and drain the lower, add small amounts of Jiudahuang (Rhei Radix et Rhizoma prepared with wine) to clear the upper and benefit the lower.
[Appendix: Leitoufeng - Thunder Head Wind]
Internal stagnation of Phlegm-Fire combined with external constraint by Wind-Heat causes headache with nodules, or sounds in the brain like thunder. Qingzhen Tang (Clear and Shake Decoction) is indicated. "Lei" (Thunder) corresponds to "Zhen" (Shock/Thunder hexagram). The Zhen hexagram symbolizes an inverted bowl; thus, Qing Helaye (Green Lotus Leaf) is used to represent the shape and color of the Zhen hexagram. In severe cases, first employ emetic and purgative methods, followed by formulas that resolve Phlegm and descend Fire. (From *Zhengzhi Huibu*)
[Appendix: Datoufeng - Big Head Wind]
Exposure to irregular Qi of Heaven and Earth allows pathogens to lodge in the meridians and attack the clear pathways upward, causing the head to swell as large as a bucket, potentially ulcerating and suppurating. Treat with Xiaodu Yin (Detoxification Decoction), differentiating treatment based on the Three Yang meridians. Wait until the stool becomes hard before considering purgation. This is a method of starting slow and ending fast. If purgation is performed hastily before the stool is hard, it will secretly damage Yuan Qi, allow pathogens to penetrate inward, and cause myriad complications. (From *Zhengzhi Huibu*)
[Selected Formulas for Toufeng]
Erchen Tang (Two-Aged Decoction): Treats symptoms of excess Damp-Phlegm in Toufeng. (Formula see Chapter on Phlegm Syndromes)
Siwu Tang (Four Substances Decoction): Treats symptoms of Blood deficiency in Toufeng. (Formula see Chapter on Stroke)
Touding San (Top-Penetrating Powder): Treats Toufeng with Brain Cold.
Ingredients: Xixin (3 stems), Gudia (7 pieces), Dingxiang (3 cloves), Nuomi (7 grains), Naobi (Borneol), She (Musk) (each size of a bean).
Grind into powder. Snuff into the nostrils corresponding to the side of the headache. After a long time, expel about one sheng of saliva, and the condition will be cured.
Chuanxiong San (Ligusticum Powder): Treats Toufeng with Stagnant Heat.
Ingredients: Qingdai (Indigo Naturalis) (2.5 qian), Manjingzi (Viticis Semen), Chuanxiong (1.2 qian each), Yujin (Curcumae Radix), Mangxiao (Natrii Sulfas) (1 qian each), Shigao (Gypsum Fibrosum) (1.3 qian), Xixin Gen (Asari Radix et Rhizoma root) (0.7 qian), Bohe (3 qian), Hongdou (1 bean).
Grind all into powder. Snuff into the patient's nostrils.
Quick Method: For lateral or central Toufeng, use 5 qian of Bamiazi (Ricini Semen), peeled, and 15 Dazao (Jujubae Fructus). Pound and grind into a paste. Roll into a strip using a chopstick, remove the chopstick, and insert into the nostril. After a while, remove it, and clear or turbid nasal discharge will stop. This treats diseases caused by Phlegm-saliva and evil Qi stagnating in the head. If caused by Fire stagnation, use Laifu Zhi (Radish Juice), instill into the nostril while lying supine: inject into the right nostril if pain is on the left, and vice versa. Another formula: Use 5 qian of Baijiez (Sinapis Semen), 5 Bamiazi, and powders of Chuanxiong and Baizhi (Angelicae Dahuricae Radix) (1 qian each). Pound into a paste and apply to the affected area; pain will decrease.
Qingzhen Fang (from *Baoming Ji*): Treats Leitoufeng.
Ingredients: Shengma (Cimicifugae Rhizoma), Cangzhu (Atractylodis Rhizoma) (4 liang each), Helaye (Lotus Leaf) (1 piece).
Decoct in water.
Xin Zhi Fang (New Formula): Treats Leitoufeng, capable of clearing the upper and guiding down.
Ingredients: Banxia (Pinelliae Rhizoma Preparatum) (1 liang), Dahuang (Rhei Radix et Rhizoma) (2 liang), Tianma (Gastrodiae Rhizoma), Huangqin (Scutellariae Radix) (6 qian each), Bohe (3 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (3 qian).
Make pills with water. Swallow 2 qian with clear tea before bed, until Phlegm is resolved.
Xiaodu Yin (from Li Dongyuan): Treats Datoufeng.
Ingredients: Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma) (0.5 liang each), Renshen (Ginseng Radix), Juhong (Citri Reticulatae Pericarpium Rubrum), Xuanshen (Scrophulariae Radix), Gancao (3 qian each), Lianqiao (Forsythiae Fructus), Niulizi (Arctii Fructus), Jiegeng (Platycodonis Radix), Banlangen (Isatidis Radix), Mapibo (Euphorbiae Pekinensis Radix) (1 qian each), Baijiangcan (Bombyx Batryticatus), Shengma, Fangfeng, Bohe, Danggui (Angelicae Sinensis Radix) (2 qian each).
If constipation exists, add 1 qian of Dahuang for mild purgation.