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.