Headache is one of the commonest symptoms for which patients seek medical help. In most cases, the pain is not related to the brain and meninges. Many of the extracranial organs are prone to give rise to pain, but the muscles and arteries of the scalp are the commonest source of headache. In the latter case, acupuncture seems to be the most satisfactory therapy, though drugs, either chemical in Western medicine or herbal in Chinese medicine, are also frequently used.

 

Syndrome Differentiation

I. Headache due to Exogenous Affections

1. Wind-Cold

Headache precipitated or aggravated by exposure to wind and cold, referring to nape, and alleviated by warmth, no thirst, maybe accompanied by stuffy and runny nose, thin white tongue coating, and floating and tense pulse.

2.Wind-Heat

Headache accompanied by distension feeling, aggravated by warmth, flushing face, thirst, maybe accompanied y fever and constipation, thin yellow tongue coating, and floating, rapid pulse.

3. Wind-Damp

Headache as if the head were tightly bound, heaviness feeling all over the body, oppression feeling in the chest, impaired appetite, loose stools, white greasy tongue coating, and soft pulse.

II. Headache due to Endogenous Injury

1. Exuberance of Liver Yang

Headache, marked at the temporal region, aggravated by anger, accompanied by dizziness, irritability, irascibility, insomnia, or hypochondriac pain and bitterness in the mouth; thin yellow tongue coating, and stringy, rapid pulse.

2. Qi Deficiency

Dull pain in the head, aggravated by fatigue, accompanied by lassitude, lack of strength, anorexia, palpitations, shortness of breath, sometimes aversion to cold with cool limbs; thin white tongue coating, and thready, weak pulse.

3. Blood Deficiency

Headache, dizziness, palpitations, insomnia, dreamful sleep, blurred vision, numbness of the limbs, pale tongue, and thready pulse.

4. Kidney Insufficiency

headache wit a feeling of emptiness, accompanied y dizziness, tinnitus, aching and weakness of the lower back and legs; reddened tongue, and deep, thready ad weak pulse.

5. Phlegm-Damp

Headache with feeling of haziness, oppression in the chest, nausea and even vomiting, white greasy tongue coating, and stringy, slippery pulse.

6. Blood Stasis

Persistent pricking or stabbing headache with fixed location, purple tongue or purple spots on the tongue, and stringy, hesitant pulse.

Herbal Medication

I. Headache due to Exogenous Affections

1. Wind-Cold

Principle of treatment: To dispel wind-cold.

Formula of Choice: Chuanxiong Chatiao San (Tea-Blended Ligusticum Powder).

2. Wind-Heat

Principle of treatment: To dispel wind-heat.

Formula of choice: Sang Ju Yin (Decoction of Mulberry Leaf and Chrysanthemum).

II. Headache due to Endogenous Injuries

1. Exuberance of Liver Yang

Principle of treatment: To soothe the Liver and subdue the exuberant yang.

Formula of choice: Tianma Gouteng Yin (Decoction of Gastrodia and Uncaria Stem).

2. Qi Deficiency

Principle of treatment: To replenish qi.

Formula of choice: Buzhong Yiqi Tang (Decoction for Reinforcing the Middle Energizer and Replenishing Qi); add Rumulus Cinnamomi (cinnamon twig) and Herba Asari (manchurian wildginger) to the decoction if there is aversion to cold wit cool limbs.

3. Blood Deficiency

Principle of treatment: To nourish blood.

Formula of choice: Siwu Tang (Decoction of Four Ingredients) plus Flos Chrysanthemi (chrysanthemum flower) and Fructus Viticis (chastetree fruit)

4. Kidney Insufficiency

Principle of treatment: To replenish Kidney yin.

Formula of choice: Qi Ju Dihuang Tang (Rehmannia Decoction with Wolfberry and Chrysanthemum).

5. Phlegm-Damp

Principle of treatment: To remove damp and resolve phlegm.

Formula of choice: Erchen Tang (Decoction of Pinellia Tuber ad Tangerine Peel) plus Radix Angelicae Dahuricae (dahurian angelica root).

6. Blood Stasis

Principle of treatment: To remove blood stasis.

Formula of choice: Tao Hong Siwu Tang (Decoction of Four Ingredients wit Peach Seed and Safflower) plus Radix Angelicae Dahuricae (dahurian angelica root).

Patent medicines

Wind-cold headache: Chuanxiong Chatiao San (Te-blended Chuanxiong Powder), 2 times a day.

Wind-heat headache: Xiong Ju Shangqing Wan (Chuanxiong-Chrysanthemum Pill for Clearing the Head), 2 times a day.

Phlegm-damp headache: Banxia Tianma Wan (Pinellia-Gastrodia Pill), 2 times a day.

Liver-yang headache; Longdan Xiegan Wang (Pill of Gentian to Purge the Liver), 2 times a day.

Headache due to depressed Liver qi: Dan Zhi Xiaoyao Wan (Ease Pill with Moutan and Gardenia), 2 times a day.

Headache due to Kidney yin deficiency: Qi Ju Dihuang Tang (Rehmannia Pill with Wolfberry and Chrysanthemum), 2 times a day.

Headache due to qi and blood deficiency: Renshen Guipi Wan (Spleen-Invigorating Pill with Ginseng), 2 times a day.