Headache is a common clinical disease, and most of the treatment is based on wind, yang, fire and stasis, etc. In addition, some headaches are caused by factors such as deficiency of positive energy.
Etiology and pathogenesis
The nature of deficiency cold headache should be based on the deficiency of positive qi, involving various factors such as qi, blood, yin and yang, and involving the spleen, kidney, liver and other organs.
The spleen and the stomach are the origin of the postnatal period and the source of biochemistry of qi and blood. In most cases, headaches are caused by improper diet, hunger and satiety, or by physical weakness after illness and childbirth, excessive fatigue or blood loss, deficiency of both qi and blood, weakness of the spleen and stomach, insufficient source of transformation, deficiency of qi, failure to raise clear yang, and deficiency of blood, failure to nourish brain marrow. If the spleen is not able to raise the clear, the stomach is not able to harmonize with the descending, and the qi and blood cannot reach the head, the tendons and veins of the head are also deprived of the moistening of qi and blood. If the spleen is not healthy, water and fluids are not properly distributed, phlegm and dampness are generated internally, clouding the clear space and blocking the clear yang, resulting in headache. According to Ye Tianshi, “headache is caused by the failure of clear yang to rise and the fire and wind to take advantage of the deficiency to enter”. It means that diet and fatigue damage the spleen and stomach, which affects the biochemical and distribution of qi and blood, and that clear yang does not rise and internal wind moves, which is an important cause of headache.
The kidney is the root of the innate nature, which is the main reservoir of essence and marrow, and fills the brain with hair and glory. Ling Shu? The Jing and Veins” says: “When a person is born, he first becomes the essence, and the essence becomes and the brain marrow is born.” The brain is the sea of marrow, which is created by the essence. If it is due to kidney, it is mostly due to deficiency of endowment, long time deficiency of kidney essence, or overwork and tiredness, indiscipline in intercourse, depletion of kidney essence, loss of nourishment in long term disease, “the injury of five organs will be poor to the kidney”, resulting in the void of the medulla; or yin loss and yang, kidney yang is weak, cold is born from within, clear yang is not open, headache is made; or kidney yin deficiency, yin deficiency and wind movement, water does not contain wood, wind and yang up disturbance, resulting in headache. The headache is caused by a deficiency of kidney yin, a deficiency of yin and wind, and a lack of water to contain wood.
The liver collects blood, and uses yang with yin, with blood as the basis and qi as the use. In the Spiritual Pivot? The Five Tones and Five Flavors says: “The birth of a woman is surplus to Qi and deficient to Blood.” The liver is often female, and its own physiological characteristics determine that its yin and blood are easily deficient, so if the liver does not collect blood, it cannot nourish the liver wood, and the hyperactive wood qi attacks the clear orifices and causes headache, that is, as Chen Lianfang said, “Women? The deficiency of blood and the loss of nourishment of the clear orifices can also lead to headache.
The etiology of headache is complex and varied, and the pathological changes of deficiency-cold headache are mostly purely deficiency, but some of them are deficiency-based and actual symptoms are the standard, causing actuality due to deficiency and mixed with actuality. For example, deficiency of spleen generates phlegm, and phlegm obscures the clear space and blocks the clear yang; deficiency of kidney water, hyperactivity of liver yang, and upward disturbance of wind and yang; deficiency of yang qi, and cold evil is directly in the middle; deficiency of positive qi, and there is no way to encourage qi and blood to run, and qi and blood are stagnant. This leads to wind, phlegm, cold, stasis and other factors of treatment. There are often cases of deficiency cold headache showing the symptoms of real heat, “to the extent that deficiency has Sheng Hou”. In all such cases, deficiency is the root cause of the disease, and the bias of the origin and the effect of the cause and effect should be clearly investigated.
Treatment
1.Qi deficiency: headache is incessant, stopping at times, violent in case of strain, pale face, tiredness and weakness, fear of cold and less breath, light and tasteless mouth, poor appetite, light red tongue with thin white coating, thin and weak pulse. Treatment: Benefit qi and promote clearing, representative formula: tonifying Zhong Yi Qi Tang. Radix Astragali, Radix Codonopsis, Rhizoma Atractylodis Macrocephalae, Radix Bupleurum, Radix et Rhizoma Gastrodiae, Rhizoma Chuanxiong, Pericarpium Citri Reticulatae, Radix Glycyrrhizae. If insomnia, forgetfulness, add Poria, roasted Yuan Zhi, jujube; with hand and foot insensibility, loose stools and cold, add cinnamon, made of slices of sophora.
2, blood deficiency does not glory evidence: headache and eye blossoms, sometimes dizzy, pain vague, less color, fatigue, palpitations and palpitations, restless sleep at night, light tongue, thin coating, weak pulse. Treatment: Nourishing Yin and nourishing Blood. Radix Angelicae Sinensis, Radix Paeoniae Alba, Radix Rehmanniae, Rhizoma Ligustici Chuanxiong, Rhizoma Cranberry and Chrysanthemum. If blood does not nourish the heart, palpitations and sleeplessness, add fried jujube seeds, cypress seeds and longan meat. If the body is tired and lazy, with little energy and lazy speech, with obvious qi deficiency, add Radix Codonopsis Pilosulae, Radix Astragali, Atractylodes Macrocephala. If tinnitus, false annoyance, little sleep and early awakening, add He Shou Wu, Fructus Lycii, Huang Jing.
3, kidney deficiency and loss of nourishment evidence: headache and empty, each with dizziness, waist and knee weakness, fatigue, spermatorrhea, tinnitus and less sleep, red tongue with little coating, thin and weak pulse. Treatment: Tonify the kidney and fill the essence. Radix Rehmanniae, Cornu Cervi Pantotrichum, Fructus Lycii, Cortex Eucommiae, Radix Codonopsis Pilosulae; Rhizoma Polygonati, Radix Angelicae Sinensis, Radix Puerariae Sinensis, Rhizoma Chuanxiong. If the headache is cold, the face is white, the extremities are not warm, the tongue is pale, the pulse is sunken and slow, add Xian Ling Spleen, Bacopa monniera, and Pieces of Pith. In case of seminal emission with frequent urination, add gorgonian, mulberry cuttlebone, and tribulus terrestris.
4. Yang deficiency and cold condensation: vague headache, unending, aggravated by cold, cold extremities, hidden cold in the back of the neck. The tongue is light and dark, with thin white fur and a sunken and thin pulse. Treatment: Warming Yang and dispersing cold. Representative formula: Ephedra, Radix et Rhizoma, Fine Pine Soup. Ephedra, Radix et Rhizoma Pseudostellariae, Radix et Rhizoma Hosannae, Chuanxiong, Angelicae Dahuricae, Ligustrum. If there is tiredness and weakness, sweating and shortness of breath, add Astragalus and Radix Codonopsis. If there is soreness and weakness of the waist and knees, add Herba Cistanches, Deer horn tablets.
Dialectical treatment experience
1.On the idea of dialectical evidence
Identify the origin of the disease: deficiency headache is often caused by deficiency of qi, blood, yin and yang, and deficiency of the functions of the internal organs, resulting in the body’s meridians and tendons, organs and orifices, and the limbs and bones being deprived of glory and nourishment, with a slow onset, long onset, and a preference for pressing, especially in case of labor.
Identify the course of the disease: the malfunction of the qi and blood of the internal organs, the disease is prolonged, the course of the disease is long and not easy to solve quickly. Headache”: “Anyone who diagnoses headache should first examine the long and temporary, and then identify the surface and the inside. Those who have temporary pain must be due to evil qi, and those who have long illness must have both yuan qi.”
Identifying the time of onset: deficiency symptoms are mostly seen in headaches that last for a whole day, seemingly painful but not painful, and sometimes stopping, with the pain in the morning being very severe, mostly due to Qi deficiency; intensifying in the afternoon, due to Blood deficiency. In women, the liver does not collect blood, resulting in hyperactivity of liver yang, and the headache usually occurs during or after menstruation.
Identifying the nature of headache: headache is caused by deficiency of kidney essence and loss of filling of brain marrow; deficiency of Yin and Blood and loss of nourishment of the clear orifices, so the headache is vague; deficiency of middle energy and inability to promote glory, so the headache is incessant.
Identify the triggering factors: headache caused by deficiency of Qi is especially severe in case of labor; blood deficiency without glory is common when menstruation consumes blood or excessive thinking; Yang deficiency with cold condensation is common in case of wind and cold.
Identify concurrent symptoms: in case of deficiency of Qi and Blood, it is accompanied by fatigue, pale white lips and nails, dizziness and dizziness; in case of deficiency of Yang, it is accompanied by depression, cold body and cold limbs, and loose stools; in case of deficiency of kidney essence, it is accompanied by soreness and weakness of the waist and knees, tinnitus and deafness, and forgetfulness and trance.
2.Regulating Qi and Blood
For those with deficiency causing actuality and mixed deficiency and actuality, one should not just warm up the body, but take into account both the symptoms and the root cause, and attack and supplement both. For headaches caused by Qi and Blood disorders, and those caused by Qi and Blood dishonor, Qi and Blood stagnation will occur over time. In addition to warming and tonifying, it is also necessary to promote paralysis and de-stagnation of qi and blood to eliminate stasis and relieve pain. The combination of nourishment and de-stagnation, the combination of tonification and supplementation, and the coordinated treatment will help to eliminate the painful pathology by tonifying the deficient qi and blood and moving the stagnant qi and blood. For nourishing Qi and nourishing Blood, Astragalus, Radix Codonopsis, Radix Angelicae Sinensis and Radix Rehmanniae; for promoting Qi and Blood circulation, Chuanxiong, Yanhuosuo and Jiang Huang are used, among which Chuanxiong can invigorate Blood circulation and resolve blood stasis, move Qi in Blood and dispel wind in Blood, leading all medicines upward to the head and directly to the place of disease, treating headaches of all meridians. It is warm and dry in nature, so it is combined with white peony to make it.
3.About nourishing Yin and nourishing Blood
If there is deficiency of Yin in liver and kidney, water does not contain wood and wind is disturbed, it is necessary to nourish Yin of liver and kidney; wind arises due to blood deficiency, pain arises due to wind agitation, treating wind first treats blood, blood moves and wind is extinguished, and it should be combined with blood medicine. Yin and Blood are of the same origin, where Yin and Blood are deficient, there are similarities in symptoms, and clinical examination should be made to identify those who are deficient in Yin, the tongue is red and dry, with little or no moss and a fine pulse; while those who are deficient in Liver and Blood have a light red tongue, or slightly red at the edge, with a thin white moss and a non-counting pulse. The liver and kidney yin is often nourished with raw earth, white peony, Chinese wolfberry, chasteberry, ink dry lotus, and the liver blood is often supplemented with angelica, rehmannia, mulberry, shouwu, aconite, etc.
4.About worm medicine
The deficiency cold headache is mostly chronic headache, with long duration and difficult to be cured. The long-standing disease and long-standing pain enter the luo, and the wind, phlegm, cold and stasis condense in the luo, and the positive deficiency is unable to promote the operation of qi and blood. Worm medicine for flesh and blood sentient products, the form is better than the gas, good at running, search the wind to pick up the luo, nowhere to go, fierce and fast. Therefore, Ye Tianshi said: “by insects and ants in the blood search, in order to attack through the evil knot”.
5.About the application of Radix et Rhizoma
Radix Aconiti is pungent and hot, tonifying fire and helping Yang, warming and dispersing cold and relieving pain. It is effective for headaches caused by deficiency of spleen and kidney yang and cold condensation of meridians. It is common to see headache aggravated by cold, cold extremities, emaciated appearance, pale or blue face, pale mouth without thirst, full of fluid, fat and white tongue. The author’s clinical evidence, whenever I see the back of the neck through the cold, as well as the ulnar pulse is not God, sunken and thin want to die, then must use the Pillow, repeatedly built a miraculous success.
6.About sedation and tranquility
Most of those who have cold headache, especially those who have been ill for a long time, have trouble sleeping at night, have difficulty sleeping because of the headache, or have shallow dreams and sleep. The disease is caused by deficiency of qi and blood and loss of nourishment of the heart and mind, or deficiency of kidney yin and lack of intercourse between the heart and kidney. Therefore, in the treatment of cold headache, we should include tranquilizing herbs such as Fu Shen, Neroli, Sour Jujube and Longan.